Auto Insurer Sues Doctor, Other Parties For Alleged Insurance Fraud
By Lindy Washburn and Barbara Williams, The Record (Hackensack, N.J.) | |
McClatchy-Tribune Information Services |
The five-count complaint by
The suit claims that Lipsky, a
The people, identified only by their initials and claim numbers, were treated at the medical practices and then referred to either the Essex Surgery Center in
Lipsky was an owner or part-owner of each of the medical practices and the two surgical centers, either personally or through a family trust, the suit said. But patients were not informed of that interest, in violation of the Codey Act, which prohibits physician self-referral, the suit said. The state law is intended to ensure that patients receive treatment that is medically necessary, and not done to enrich the medical provider.
Some of the services were not necessary or in the best interests of the patients, said the complaint filed in
A spokesman for Lipsky said the lawsuit would not succeed.
"Dr. Lipsky feels that if the
The lawsuit was filed as an amended complaint to a 2006 case that went to the state
Selective wanted the information to help its investigation of the "apparent interlocking financial interests" of the centers and the doctors.
Since then, Thursday's filing said, Selective had uncovered information independently that supports its "suspicion that the defendants were operating in violation of the law."
The original 2006 complaint was "frivolous," Maer said, and "this action is simply Selective filing a motion to amend their previously unsuccessful lawsuit."
But the industry said the lawsuit had significance beyond Selective and Lipsky.
"We think that the ownership and oversight of ambulatory surgery centers and potential illegal self-referrals is a significant issue in
Selective is one of the state's smaller automobile insurers, with less than 10 percent of the market, she said.
Lipsky and Tamara Dunaev are the principal owners of the private investment group,
They also operate four ambulatory surgery centers, including Essex Surgery Center, and others in
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Ind. Doc To Be Sentenced For Insurance Fraud
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