N.J. Supreme Court Reviewing Landmark Fraud / RICO Case
– By Jeffrey Randolph, Esq.
It has become a cottage industry for no-fault insurance carriers to sue doctors, including chiropractors, for alleged fraud and racketeering cases in state and federal courts under the RICO Act and Insurance Fraud Prevention Act (IFPA). The impetus for these suits is to force doctors to waive all outstanding claims; pay money back to the carrier; and agree on forward-looking billing restrictions such as an agreement to cap all physical medicine visits at 50 visits or not do certain procedures and bill the carrier for them.
Doctors have previously been partially successful in federal court cases convincing judges to dismiss the RICO lawsuits against doctors in favor of mandatory no-fault arbitration but no federal judge has dismissed the associated IFPA claims, resulting in the case continuing to proceed in federal court.
A New Jersey Superior Court judge recently issued an important decision on a complaint filed by Allstate against a multidisciplinary practice which included chiropractic physicians under both the IFPA and RICO. Judge Christopher Rufano, JSC, sitting in Middlesex County, dismissed the entire complaint filed by Allstate in favor of mandatory no-fault arbitrations, including for the first time the IFPA claims.
In his decision, Judge Rufano found that the express language of the Automobile Insurance Cost Reduction Act, implemented in 1998 to provide for mandatory PIP arbitrations of no-fault claims, required all of the claims to be pursued in Forthright Arbitrations and not Superior Court litigation.
(A few months after Judge Rafano issued his decision, the Third Circuit Court of Appeals issued an identical determination in its “Precedential” decision in GEICO v. Mt. Prospect Chiropractic Center, Civil Action 23-1678 [3rd Cir. 2024].)
This decision is unprecedented in remanding the entirety of a fraud and RICO case against doctors to mandatory no-fault arbitration. Allstate appealed the case to the mid-level state appellate court, which reversed the decision even though it is completely contradictory to the Third Circuit’s precedential decision in Mt. Prospect.
On this basis, the doctors have petitioned the New Jersey Supreme Court to review the decision and issue the final determination on this important issue. As lead counsel for a number of chiropractors in the case, I am confident that the Supreme Court will accept the case, reverse the appellate decision, and hold consistent with the Third Circuit Court of Appeals that NJIFPA and RICO cases belong in arbitration. Stay tuned as the Supreme Court proceedings progress.
Jeffrey Randolph is the legal counsel for the Association of New Jersey Chiropractors and operates a private practice in Glen Rock, N.J.
Note: The information provided is for general guidance on matters of interest only and may not take into account particular facts relevant to your individual situation. The application and impact of laws and health care can vary widely based on the specific facts involved. Given the changing nature of laws, rules and regulations, there may be omissions or inaccuracies in information contained in these materials. Accordingly, the information you receive is provided with the understanding that the author is not herein engaged in rendering legal, accounting, tax, health care or other professional advice and services; nor is he providing specific advice with regard to your practice, the treatment of any specific illness, disease, deformity or condition, or any other matter that affects trade, commerce, or legal rights of others. As such, this article should not be used as a substitute for consultation with professional accounting, tax, legal, health care, or other competent advisers. Before making any decision or taking any action, you should consult an appropriately trained professional.
Change to British Columbia DC Status
– By Don Nixdorf, DC, Esq.
British Columbia chiropractic doctors are no longer registrants of the College of Chiropractors of BC (1934 Chiropractic Act). BC chiropractic doctors are now known, among three other professions, as registrants of the College of Complementary Health Care Professionals.
History of legislation includes one jurisdiction implementing major social change, often the precedent for another jurisdiction. The most notable was the increased privatization of health care from 2001 through 2004 in provinces; first in BC, then through to Ontario.
Dr. Don Nixdorf is the legal counsel for the British Columbia Chiropractic Association, and has served on both association and college regulatory boards.
Editor’s Note: This column by the National Association of Chiropractic Attorneys (NACA: https://nacattorneys.com/) features legal updates as they relate to chiropractors. For previous articles, visit the NACA online columnist page.
