Allstate Can Proceed with Recovery in Texas RICO Case: Fifth Circuit
Article 0 Comments Allstate can move forward in its recovery of $4.7 million it paid to settle fraudulent medical claims with a Houston, Texas medical facility, the U.S. Court of Appeals for the Fifth Circuit has ruled. The federal appellate court reversed a lower court’s ruling that Allstate’s RICO claims failed because the insurer didn’t sufficiently allege that it relied on fraudulent bills when settling the claims. Rather, the Fifth Circuit said that Allstate adequately showed it was the victim of a RICO scheme involving more than 600 claimants. Beginning in 2018, Dr. Akash Bhagat and defendants enteredinto agreements with personal injury attorneys to refer clients to Memorial Heights Emergency Center under letters of protection guaranteeing payment from future insurance settlements, court proceedings say. Defendants charged car accident patients at emergency billing codes, rates nearly triple those normally charged. Visits to Memorial Heights soon doubled, with some patients driving more than 90 miles and bypassing other medical centers to reach the “inconspicuous facility in a modest shopping center far away from any major thoroughfares.” Patients received expensive diagnostic tests, including CT scans, only to be discharged without further treatment, court proceedings say. Memorial Heights would then forward bills to the...