Law Street Media

Pharmacy Sued by GEICO After Submitting $2 Million in Allegedly Fraudulent Claims

pharmacy medicine capsule pill in production line at medical factory

A suit was filed by plaintiffs Government Employees Insurance Company (GEICO) and related entities against defendants Ideal Care Pharmacy, Inc. and Leonid Naishuler on Monday in the Eastern District of New York. The complaint alleges that the defendants submitted over $2 million to the plaintiffs in fraudulent pharmaceutical bills.

Beginning in 2020, the plaintiffs argue that the defendants submitted thousands of fraudulent claims to the plaintiffs. The claims were seeking payment for topical pain products, oral nonsteroidal anti-inflammatory drugs, and muscle relaxers, which the complaint asserts were medically unnecessary.

The fraudulent pharmaceuticals were given to individuals who were victims of automobile accidents and had insurance coverage policies with GEICO. The defendants were able to acquire the fraudulent pain-relieving products at a low cost, and then “dispense and bill for them at exorbitant prices.”

Ideal Care and Naishuler also purportedly entered into agreements with entities that primarily treat no-fault patients. These alleged agreements detailed that “in exchange for kickbacks and other financial incentives, the Defendants steered the Prescribing Providers and Clinic Controllers to direct large volumes of prescriptions” for the aforementioned pain-relieving products.

The heightened number of prescriptions for products that the defendants acquired at a low cost led to “egregiously inflated” claims being submitted to GEICO. The complaint explains that single tubes of gel or ointment would be submitted for up to $2,599.

GEICO contends that the defendants stole more than $527,000 from them through the inflated claims. The defendants allegedly still have, in process, over $1.17 million in fraudulent claims.

The plaintiffs conclude that through the defendants’ illegal and collusive relationships with prescribing providers, the medically unnecessary prescribed pain-relieving products that they received at a low cost, and their continual submitting of fraudulent claims to the plaintiffs, they intentionally engaged in a fraudulent scheme.

The complaint cites four claims for relief, including claims for common law fraud, unjust enrichment and a violation of the Racketeer Influenced and Corrupt Organizations Act. The plaintiffs are seeking declaratory relief, $527,000 in damages as well as treble and punitive damages, litigation fees, interest, and any other relief deemed proper by the Court.

The plaintiffs are represented by Rivkin Radler LLP.

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