RICO Action Against Medical Providers Raises Discovery Difficulties

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In Government Employees Insurance Co., et al. v. Mark A. Cereceda, et al., CASE NO. 19-22206-CIV-ALTONAGA/GOODMAN, United States District Court Southern District Of Florida Miami Division (January 15, 2021) where Plaintiffs filed a 406-page Complaint. Specifically,Geico sued chiropractor Mark A. Cereceda and others who purportedly provided fraudulent healthcare services.

ZALMA OPINION

An insurer alleging fraud based on a predetermined treatment protocol should not have to prove that each claim, in a vacuum, is fraudulent. It can also use specific cases to prove the pattern or fraud but then it must respond in detail to discovery requests. In that regard I have seen in my practice medical billing and reporting that was identical to multiple patients except for the name of the patient. If Geico can show that type of fraud it will have no problem with the RICO action proof and will not need to answer interrogatories about the thousands of fraudulent claims.