GEICO alleges that the defendants submitted, or caused to be submitted, hundreds of fraudulent no-fault insurance charges, billing for equipment that was not medically necessary, not properly prescribed, or misrepresented in type and value. The complaint states that Grandview Supply, which is not a licensed healthcare provider, made unauthorized decisions about what equipment to dispense and typically billed for items with the highest reimbursement rates. For example, the company allegedly billed for custom-fitted or custom-fabricated devices when only off-the-shelf products were provided. In another example, it submitted charges for “egg crate mattresses” using codes for full-size foam rubber mattresses, increasing the reimbursement from $19.48 to $155.52 per item.

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GEICO accuses Queens supplier of orchestrating $1 million RICO fraud
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