State Farm Sues Fakhoury Medical and Chiropractic Center for $2.5 Million in Fraudulent Massage Claims

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USA Herald – State Farm Automobile Insurance Company and State Farm Fire and Casualty Company have filed a lawsuit against Fakhoury Medical and Chiropractic Center, P.L.L.C., Riadh A. Fakhoury, D.C., and Nagy Shanawany, M.D. in the U.S. District Court for the Middle District of Florida.

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The case, State Farm Automobile Insurance Company et al. v. Fakhoury Medical and Chiropractic Center PLLC et al., case number 5:23-cv-00153, was filed on March 6, 2023.

According to the complaint, the defendants are accused of filing $2.5 million in fraudulent claims for medical services allegedly provided to automobile accident victims eligible for Personal Injury Protection (PIP) and Medical Payments Coverage (MPC) benefits. The nature of the suit is listed as “Other Fraud” with a cause of action of “28 U.S.C. § 1332 Diversity-Fraud.”

The lawsuit targets Fakhoury Medical and Chiropractic Center PLLC, Dr. Riadh A. Fakhoury, and other defendants for their alleged involvement in the fraudulent scheme. The complaint alleges that the defendants submitted false and fraudulent claims to State Farm for medical services that were not medically necessary or were not actually provided to the patients.

The complaint further alleges that the defendants engaged in a pattern of fraudulent billing practices, including billing for services that were not rendered, billing for services that were not medically necessary, and billing for services at inflated rates. The complaint also alleges that the defendants falsified medical records to support their fraudulent claims.

State Farm contends that the Center invoiced for services labeled as “manual therapy,” a category not covered under no-fault benefits as they are classified as “non-compensable massages.”

State Farm is seeking damages in the amount of $2.5 million, as well as interest, costs, and attorney’s fees. The insurance company is also seeking injunctive relief to prevent the defendants from engaging in further fraudulent activities.

The outcome of this case could have significant implications for the healthcare industry and could serve as a warning to other healthcare providers to ensure that their billing practices are in compliance with the law.

It remains to be seen how this case will unfold and what impact it will have on the healthcare industry. However, one thing is certain: insurance companies are taking a strong stance against insurance fraud and are willing to take legal action to protect their interests.

In conclusion, State Farm Automobile Insurance Company et al. v. Fakhoury Medical and Chiropractic Center PLLC, is a case that highlights the ongoing issue of insurance fraud in the healthcare industry. State Farm is seeking damages in the amount of $2.5 million for fraudulent claims submitted by the defendants.

 

By Samuel Lopez | Legal News Contributor for USA Herald

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