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Few people in Florida are unfamiliar with 411-PAIN and their plethora of advertisements. Parent company Path Medical has been heavily advertising the medical, accident, and legal referral service in the state for several years. As a result, the company’s jingles and remixes of popular songs are regularly stuck in Floridians’ heads and hummed during long car rides.

The widespread recognition of 411-PAIN and its television spots doesn’t equate to a fantastic reputation. Just as most Florida residents are familiar with the advertising, they are similarly aware of the company’s dubious reputation. For every jingle, there’s been a negative review or opinion article that warns of poor referrals and worse customer service. Yet, a questionable review pales in comparison to the 193-page complaint filed against 411-PAIN by Government Employee Insurance Company (GEICO).

What’s Alleged in the GEICO Complaint?

GEICO filed a lengthy complaint against 411-PAIN in the Florida Middle District Court at the end of November. The complaint contained several allegations of medical fraud and fraudulent activity by 411-PAIN that amount to over $15,000,000 in damages. These allegations center on a substantial number of no-fault insurance charges 411-PAIN, through Path Medical, submitted to GEICO.

If substantiated, the fraudulent claims would be illegal under several Florida laws, including Florida’s Clinic Act, the state and federal Anti-Kickback Statute, and the Self-Referral Act.

GEICO alleges that in 2014 Path Medical started requesting insurance proceeds for medical procedures that were medically unnecessary, non-existent, unlawful, or unavailable for insurance payments. These procedures spanned a wide range of medical treatment, including initial consultations or examinations with a patient, follow-up appointments and check-ups, medical scans and diagnostic testing, and physical therapy. Path Medical also submitted several fraudulent claims for chiropractic services that were either unnecessary or illusory.

How Are These Allegations Connected to Car Accidents?

The relationship between Path Medical and 411-PAIN facilitated a huge number of the alleged fraud. Back in 2012, chiropractic practice owner Robert Lewin owned several separate chiropractic offices in the State of Florida. He, correctly, thought it would be more profitable to combine these fragmented offices into a single conglomerate of chiropractic services. He soon after created 411-PAIN to act as the referral service to the Path Medical chiropractors.

411-PAIN also acted as a finding service for the medical practitioners and law firms that worked with Path Medical. The interconnection between referral service, law firm, doctors, and chiropractors was an ideal arrangement for attracting individuals injured in a Florida car crash. Lewin realized that a particular aspect of the laws regarding Florida car accidents could lead to a big payday.

GEICO provides Personal Injury Protection, or No-Fault Protection, to Florida residents. A form of car insurance in the state, these policies allow a driver to claim up to $10,000 in medical reimbursement from their car insurance provider. This insurance money is accessible in the state irrespective of fault for the Florida car crash. It’s a much faster way to receive insurance payments to cover medical expenses.

Unfortunately, 411-PAIN and Path Medical saw these no-fault or PIP payments as an unlawful opportunity. As part of these insurance claims to GEICO, Path Medical would include medical services that weren’t ever provided or weren’t medically required by the patients. Further, the complaint alleges that even the medical procedures properly provided are void because they were provided under unlawful circumstances.

411-PAIN as an Illegal Business

GEICO argues in its complaint that 411-PAIN’s business structure is illegal under both the Self-Referral Act and Patient Brokering Act. The first statute, the Self-Referral Act prohibits any medical professional or health care provider from referring patients to a practice or service that the individual has a financial interest in. This implicates the entire premise of 411-PAIN as a referral service and business.

The Patient Brokering Act similarly prohibits any medical professional from exchanging money for clients. The term money can include any type of financial benefit, whether that is a bribe, kickback, rebate, or bonus. This ban on paying for clients extends to patient referrals.

To learn more about GEICO’s case against 411-PAIN, to learn more about PIP claims and payments, or to discuss other circumstances around a Florida car crash, call Aronfeld Trial Lawyers at 1-866-597-4529 or (305)-441-0440, or reach our office 24/7 by email at [email protected].