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State Farm v. 22065

In State Farm v. 22065 filed in 2013, State Farm claimed that a self-referral violation took place.  There were approximately 20 clinics owned by one chiropractor. 

State Farm claims that the chiropractor owned and advertised a 1-800 number and callers were “referred” to the clinics owned by the chiropractor.  State Farm claims this was an improper self-referral of a “patient” but I disagree.  State Farm claims this was an improper advertisement that violated Board of Chiropractic Rules because it failed to disclose the chiropractor/owner and failed to include information the Board requires.

When the Florida Bar started investigating the 1-800 number, the chiropractor/owner of the 1-800 number “gave away” the 1-800 number to his cousin and had all ownership go to a corporation in the cousin’s name.

In a deposition, the clinic’s right hand man and office manager stated that (1) their software listed all of the referrals to and from lawyers and (2) that he deleted it because he did not want to produce it because he was “tired of being asked about it in depositions.”

This was an interesting case because State Farm sued, in my opinion, over a “cozy relationship” between a particular law firm and the clinic, and possibly evidence of a “quid pro quo” relationship between them.  The claim that there was a “self-referral” between the 800-number and the clinics was not based on law (i.e. a “caller” of a 800-number is not a “patient” that would trigger patient brokering/self-referrals law in my opinion).

DISCLAIMER

This is based on a real court case that was previously filed against a medical provider/doctor.  The case number has been partially redacted and names have been changed to protect the Defendants’ names.  This example is posted to help educate others on the laws and potential pitfalls.  This posting is not intended to embarrass or defame anyone.   I have limited the information and simplified some of the facts in the lawsuit to reflect key points and make a complicated case easier to understand.  This “example” is directly from a complaint filed by an insurance company; therefore, I am using the facts THEY presented.  There are always two sides to a story so please understand this is just one side of the story.  This information was found through records available to the public.

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