Stacy Frye v. Pediatric & Adolescent Advance Care, PLLC et al.

District Court, E.D. Michigan·Decided August 19, 2026·No. 2:26-cv-10555·Unknown

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION STACY FRYE,

Plaintiff, Case No. 26-10555 Honorable Laurie J. Michelson v.

PEDIATRIC & ADOLESCENT ADVANCE CARE, PLLC et al.,

Defendants.

OPINION AND ORDER DENYING IN PART AND GRANTING IN PART DEFENDANTS’ MOTION TO DISMISS [19] For a few turbulent months in 2025, Stacy Frye, a pediatric orthopedic and sports medicine doctor, ran a practice under the umbrella of Pediatric & Adolescent Advance Care, PLLC and its owner, Dr. Faisal Mawri. Almost immediately upon joining the PLLC, Frye spotted red flags in its billing procedures. She repeatedly raised concerns. But she says little was done and her worry for her professional reputation grew. By early September—just eight months after this partnership began—Frye gave her 90-days’ notice. The PLLC waived the notice and terminated her immediately. Frye claims that her termination was unlawful retaliation for her legitimate efforts to prevent fraud on the government. She brings a retaliation claim under the False Claims Act against both the PLLC and Mawri, as well as a breach of contract and termination in violation of public policy claim under Michigan law. Defendants contend that none of Frye’s claims state a plausible claim for relief and they moved to dismiss them. (ECF No. 19.) For the reasons that follow, the motion is granted as to Frye’s breach of contract claim against Mawri but denied in

all other respects. I. “On a motion to dismiss, the district court ‘must construe the complaint in the light most favorable to the plaintiff and accept all allegations as true.” Tulis v. Bennett, No. 25-5430, 2026 U.S. App. LEXIS 672, at *2–3 (6th Cir. Jan. 9, 2026) (quoting Doe v. Miami Univ., 882 F.3d 579 (6th Cir. 2018).588 (6th Cir. 2018)). Thus,

the Court recites the facts as alleged in Frye’s complaint. In June 2025, Stacy Frye, M.D., a “pediatric orthopedics and sports medicine specialist,” entered a for-cause employment contract with Pediatric & Adolescent Advance Care, PLLC (the “clinic” or “PLLC”), to join its practice as a Physician of Non-Operative Pediatric Orthopedics & Sports Medicine. (ECF No. 1, PageID.5, 6.) Dr. Faisal Mawri, owner of the clinic, provided “general pediatric and adolescent” care to patients (alongside some other medical professionals), while Frye

was brought on to provide specialized, “non-operative pediatric orthopedic services,” primarily through referrals from Mawri and his colleagues. (See id.) Despite operating together under one PLLC, Mawri and the clinic “held out to the public” that Frye was a solo practitioner. (See ECF No. 1, PageID.6.) Frye’s employment contract provided, in relevant part, that “either party may terminate th[e] Agreement at any time, with or without cause, upon at least ninety days prior written notice to the other party.” (Id. at PageID.23.) Additionally, the PLLC could terminate Frye for material breach, provided that Frye “fail[ed] to cure such breach within fifteen (15) days after receiving written notice of such breach from

the [PLLC].” (Id.) The effective date of the contract was January 6, 2025. (Id. at PageID.5.) Frye began her work at the clinic the same day. (Id.) Problems arose not long after. First, there were some complications with getting Frye’s practice approved by several major insurance providers. (Id. at PageID.7.) As a result, Frye had a high number of out-of-network patients. (Id.) And because Defendants dragged their feet

in establishing a fee schedule for Frye’s services, her many out-of-network patients were not given “good faith estimates” of what the cost of her services would be. (See id.) This raised alarm bells for Frye, who believed this lack of transparency might violate state and federal law—specifically the Federal No Surprises Act (Pub. L. No. 116-260, § 109, 134 Stat. 1182 (2020)) and Michigan’s Suprise Medical Billing Law (Mich. Comp. Laws. § 333.23509). (Id. at PageID.8.) So Frye “repeatedly reported and opposed, verbally and in writing,” Defendants’ failure to comply with these

requirements. (Id.) Further still, Frye almost immediately detected issues in Defendants’ billing practices. (See id. at PageID.7.) The PLLC billed both private insurers and the Centers for Medicare and Medicaid (CMS) for its services, but “most” of the clinic’s bills went to CMS. (Id. at PageID.5–6.) Likewise, “more” of Frye’s services were billed to CMS than private insurers. (Id. at PageID.6.) In March 2025, Frye reported to Defendants that any patients Mawri and his team referred to her should be billed as established patients, not new patients. (Id. at PageID.8.) But Defendants “continually directed [her] to fraudulently bill for all

patients as if they were ‘new patients,’” because services to new patients are billed at a higher rate. (Id. at PageID.8, 9.) Then, in April 2025, the PLLC’s biller instructed Frye to code some of her services as “post-operative.” (Id. at PageID.9.) Frye opposed this too, explaining that as a non-surgical doctor, none of her services could be characterized as “post- operative.” (Id.) In June 2025, however, the biller continued to direct Frye to change

her codes to these “more lucrative, but factually incorrect, surgical codes.” (Id.) That same month, Frye noticed that Mawri frequently billed the government for services at the highest reimbursement rates (“level 5”), even when his clinical notes did not support billing at that level. (Id.) She also found that Mawri referred patients to her for services “that did not correspond to the purported reason for referral, that were not medically indicated, and that lacked documented examinations to support the high level of service billed to the government.” (Id. at

PageID.10). All of this, Frye says, demonstrated to her that Mawri and the clinic were up-coding and unnecessarily referring patients “in order to bill the government” more frequently and at higher rates. (See id. at PageID.8–10.) So, “in or around June 2025,” Frye reported her “concerns about the fraudulent billing” to the clinic’s CEO, Darrick Conley, “including her concern that Defendant Mawri’s documentation did not support the billing levels used, that referrals appeared to be medically unnecessary, and that she was concerned about the legitimacy of Defendants’ billing practices.” (Id. at PageID.10.) She continued these reports to Conley “throughout July and August 2025.” (See id. at PageID.11.)

In July, Frye learned that some patients had complained to the clinic that they were “scheduled for appointments for unexplained reasons,” only to later discover the visit was medically unnecessary. (Id.) Nevertheless, the clinic billed CMS for these unnecessary appointments. (Id.) Also around this time, they changed Frye’s long-held tax identification code designation from “pediatrics” to “sports medicine,” to obtain higher reimbursement rates. (Id. at PageID.12.)

Despite Frye’s complaints, the concerning practices continued. (Id. at PagID.11.) Mawri continued to instruct Frye to “bill for as many level 5 visits as possible.” (Id.) Frye continued to resist, telling both Mawri and Conley that this would “amount to fraudulent billing.” (Id.) For several months thereafter, Frye says Defendants continued to “double bill[] for her services, upcod[e], . . . and otherwise chang[e] codes she placed into medical records,” all to increase their billing revenues. (Id. at PageID.12.)

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Stacy Frye v. Pediatric & Adolescent Advance Care, PLLC et al., (E.D. Mich. 2026).

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