Government Employees Insurance Company v. Barakat

CourtDistrict Court, E.D. New York
DecidedJanuary 2, 2024
Docket1:22-cv-07532
StatusUnknown

This text of Government Employees Insurance Company v. Barakat (Government Employees Insurance Company v. Barakat) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Government Employees Insurance Company v. Barakat, (E.D.N.Y. 2024).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK GOVERNMENT EMPLOYEES INSURANCE RAN COMPANY, GEICO INDEMNITY COMPANY, OVE No (noe oe GEICO GENERAL INSURANCE COMPANY, and ( )¢ ) GEICO CASUALTY COMPANY, Plaintiffs, -against- JEAN-PIERRE BARAKAT, M.D., DR. JEAN PIERRE BARAKAT, M.D. (A Sole Proprietorship), PATRIOT MEDICAL CARE, P.C., JEB TODT HILL MEDICAL CARE, P.C., and JOHN DOE DEFENDANTS “1” through “10”, Defendants. . NICHOLAS G. GARAUFIS, United States District Judge. Plaintiffs Government Employees Insurance Company, GEICO Indemnity Company, GEICO General Insurance Company, and GEICO Casualty Company (“GEICO” or “Plaintiffs”) bring this ac- tion against Defendants Jean-Pierre Barakat, M.D., Dr. Jean Pierre Barakat, M.D. (A Sole Proprietorship}, Patriot Medical Care, P.C., JPB Todt Hill Medical Care, P.C., and John Doe De- fendants “1” through “10” (collectively, “Defendants”), alleging that Defendants defrauded GEICO in violation of the Racketeer- ing Influenced and Corrupt Organizations Act (“RICO,” 18 U.S.C. § 1962(c), (d)), by submitting hundreds of fraudulent bills for no-fault insurance charges. (See Compl. (Dkt. 1) {4 148-248.) Plaintiffs also allege common law fraud and unjust enrichment and seek a declaratory judgment as to all pending bills. id.) GEICO now moves for a preliminary injunction to stay all 43 pending no-fault insurance collection arbitrations commenced against GEICO by or on behalf of Defendants Patriot Medical

Care, P.C. (“Patriot Medical”} and JPB Todt Hill Medical Care, P.C. (“JPB Medical”) (collectively, the “PC Defendants”).! (See Not. of Mot. (Dkt, 24-1); Mot. to Stay (Dkt. 24-8) at 1, 9.) Addi- tionally, Plaintiffs request that this court waive their obligation to post security for the injunction. (See id. at 21.) For the reasons set forth below, Plaintiffs’ motion to stay the arbitration proceed- ings is GRANTED and Plaintiffs’ request that the court waive their obligation to post security is GRANTED. I. BACKGROUND? A. New York’s No-Fault Insurance Scheme In New York, an insurer is required to provide certain no-fault insurance benefits (“No-Fault Benefits”) to the individuals that they insure (“Insureds”). No-Fault Benefits cover up to $50,000 of necessary healthcare expenses that result from automobile ac- cidents. See N.Y. Ins. Law §§ 5102{a)(1), 5102(b), 5103; NLY,

1 Plaintiffs note in their opening brief, and this court takes notice, that Plaintiffs are not moving to enjoin Defendants Dr. Jean Pierre Barakat, M.D. (A Sole Proprietorship) and the PC Defendants (collectively, the “Barakat Practices”), and anyone acting or purporting to act on their be- half, from commencing any further no-fault insurance collection arbitrations or new no-fault collections litigation against GEICO because this court has previously So-Ordered Stipulations in this matter whereby (@) Jean-Pierre Barakat, M.D., the Barakat Practices, and their attorneys, agents and anyone purporting to act on their behalf have already agreed to a preliminary injunction, pending a final resolution of this action, in- cluding any appeals, enjoining and restraining them from (a) submitting any billing to GEICO in the names of the Barakat Practices, and/or (b) commencing any new arbitrations before any arbitration tribunal or com- mencing any lawsuits in any state or local court against GEICO seeking payment of No-Fault benefits on behalf of any of the Barakat Practices. (Mot, to Stay (Dkt. 24-1) at 1 n.1; see also Orders Granting Consent Mo- tions to Stay and Enjoin Collection Proceedings (Dkts. 18, 20, 22).) @ The following background is taken from the allegations of the Complaint and declarations submitted by GEICO in connection with this motion.

Comp. Codes R. & Regs. (“NYCRR”) tit. 11 § 65-1.1. These ben- efits are provided “to ensure that injured victims of motor vehicle accidents have an efficient mechanism to pay for and receive the health care services that they need.” (Compl. { 25.) Conse- quently, this legislative scheme is designed to “ensure prompt compensation for losses incurred by accident victims without re- gard to fault or negligence, to reduce the burden on the courts and to provide substantial premium savings to New York motor- ists.” State Farm Mut. Auto. Ins. Co. v. Herschel Kotkes, M.D., P.C., No. 22-CV-03611 (NRM) (RER), 2023 WL 4532460, at *1 (E.D.NY. July 13, 2023)).3 Insureds may assign their No-Fault Benefits to healthcare provid- ers in exchange for services, and in turn, the provider, rather than the Insured, files no-fault claims with the insurance company di- rectly. See NYCRR tit. 11 § 65-3.11(a) (providing that the benefits may be paid only “directly to the applicant” or “upon □ assignment by the applicant . . . directly to providers of healthcare services”). Providers are prohibited from receiving No-Fault Benefits, however, if they “fail[] to meet any applicable New York State or local licensing requirement necessary to per- form such healthcare services.” Id. § 65-3.16(a)(12); see also State Farm Mut. Ins. Co. v. Matlela, 4 N.Y.3d 313, 321 (2005). This includes, inter alia, that unlicensed professionals, Le., non- physicians, may not own or control a medical professional corpo- ration, employ or supervise other professionals, or derive economic benefit from physician services. (Compl. { 32); see N.Y. Bus, Corp. Law § 1507. Licensed healthcare services providers, including physicians, are also prohibited from paying or accept- ing kickbacks in exchange for patient referrals. (Compl. { 33); see, e.g., New York Education Law § 6512, § 6530(11), (18)-(19). Therefore, under New York No-Fault laws, a healthcare provider 3 When quoting cases, and unless otherwise noted, all citations and quotation marks are omitted, and all alterations are adopted.

is not eligible to receive No-Fault Benefits “if it is fraudulently licensed, if it pays or receives unlawful kickbacks in exchange for patient referrals, if it permits unlicensed laypersons to control or dictate the treatments or allows unlicensed laypersons to share in the fees for the professional services.” (Compl. € 35.); N.Y. Ins. Law § 5109; NYCRR tit. 11 § 65-5.0; New York Education Law §§ 6509-a, 6512, § 6530 (18)-(19), 6531. Moreover, insurers are only given 30 days to review and investi- gate claims before paying those claims to avoid risk of penalty for denying or delaying a claim. See NYCRR tit. 11 § 65-3.8(a); see also Med. Soc’y of State of N.Y. v. Serio, 100 N.Y.2d, 854, 861 (2003). After 30 days, interest begins to accrue at a rate of two percent per month, See N.Y. Ins. Law § 5106(a). Claimants may dispute unpaid no-fault claims either in a state civil action or, as at issue here, in an arbitration proceeding. See NYCRR tit. 11 8 65-4.1, et seq.; N.Y. Ins. Law § 5106(a). In arbitration proceed- ings to recover No-Fault Benefits, the process is “an expedited, simplified affair meant to work as quickly and efficiently as pos- sible,” and “[{d]iscovery is limited or non-existent.” Allstate Ins. Co. v. Mun, 751 F.3d 94, 99 (2d Cir. 2014). The proceedings “typ- ically are heard and resolved in minutes, with arbitrators conducting one hearing after another, generally in 15-minute in- tervals,” which makes it difficult for an arbitrator to “consider a pattern of fraudulent treatment.” (Kathleen Asmus Declaration (“Asmus Decl.”) (Dkt.

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Bluebook (online)
Government Employees Insurance Company v. Barakat, Counsel Stack Legal Research, https://law.counselstack.com/opinion/government-employees-insurance-company-v-barakat-nyed-2024.