S1 E52 GEICO Sues Alleged No Fault Fraud Ring

Send us Fan MailOur Deep Dive today takes a look at a civil Complaint filed by GEICO against PULSE MEDICAL CARE, P.C., Dr. Adnan Qureshi, and Irshad Syed, alongside an exhibit cataloging the disputed bills. The insurance carrier alleges a protracted, multi-year scheme to defraud it of over $1.6 million by utilizing New York's No-Fault system through the submission of thousands of medically unnecessary claims via the mail. The core mechanism of the fraud allegedly involved illegal patient referral arrangements and the illegitimate operation of the medical practice by unlicensed individuals. The lawsuit specifies that the billed services, documented in the accompanying schedule of claims, include exaggerated consultation complexity, medically unwarranted diagnostic ultrasounds (CPT 76881), and high-risk interventional procedures like Percutaneous Disc Decompressions performed by Qureshi, who allegedly lacked surgical qualifications.Let's Dive In!Support the show