Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

State Farm Mutual Automobile Ins. Co. v. Elite Health Centers Inc.

United States District Court, E.D. Michigan, Southern Division

May 31, 2017

State Farm Mutual Ins. Co., Plaintiff,
v.
Elite Health Centers, Inc., et. al., Defendants.

          OPINION & ORDER DENYING DEFENDANT'S MOTION TO DISMISS

          Sean F. Cox United States District Judge.

         Plaintiff State Farm Mutual Automobile Insurance Company (“State Farm”) brings this action against 18 defendants. Specifically, State Farm claims that Defendants have submitted fraudulent claims to the insurer under Michigan's No-Fault Automobile Act. State Farm's complaint alleges several claims of common law fraud, civil conspiracy and unjust enrichment, and a count for declaratory judgment.

         Currently before the Court is Defendant Chintan Desai's “Motion to Dismiss the Complaint for Failure to Join a Necessary Party and Failure to State a Claim.” (Doc. # 58, Def.'s Mo.”). Defendant brings his motion pursuant to Rules 9(b), 12(b)(6), 12(b)(7) and 19 of the Federal Rules of Civil Procedure. In his motion, Defendant advances two main arguments. First, Defendant argues that Plaintiff's complaint should be dismissed because State Farm failed to join Horizon Imaging, LLC. Defendant claims that Horizon is a necessary and indispensable party pursuant to Federal Rule of Civil Procedure 19. Defendant alternatively argues that the complaint's common law fraud, civil conspiracy, and unjust enrichment claims fail to state a claim upon which relief could be granted.

         Defendant's motion has been fully briefed. The Court finds that oral argument would not significantly aid in the decisional process and therefore orders that the instant motion will be decided upon the briefs. See E.D. Mich. LR 7.1(f). For the reasons that follow, the Court shall DENY Defendant's motion.

         BACKGROUND

         A. Factual Background

         Plaintiff State Farm is a corporation that engages in the business of insurance in Michigan. Plaintiff brings this action against 18 defendants, all of which played a role in an alleged scheme to defraud the insurer.

         1. The Defendants

         At the center of the alleged scheme are Defendants Derek Lawrence Bittner, D.C., a chiropractor, and Mark A. Radom, a layperson. State Farm alleges that Bittner and Radom created, own and control several entities that: (1) submit bills and supporting documentation to State Farm Mutual for chiropractic, physical therapy and medical services purportedly rendered to patients that were not actually performed or were not medically necessary; (2) that prescribe and refer patients to two locations owned by Defendant Jayson Rosett for physical therapy services that are either not performed or not medically necessary; and (3) that refer State Farm Mutual insureds to receive medically unnecessary MRIs from Horizon Imaging, LLC and from Defendant Superior Diagnostics, Inc. (Compl. at ¶ 1).

         a. The Elite Entities

         Defendant Derek L. Bittner D.C., P.C. (“Bittner P.C.”) is a Michigan professional corporation, formed in 2000. (Compl. at ¶ 203). Bittner is the resident agent and president. Bittner's wife, Ryan Bittner, D.C., is the secretary. (Id.). Defendant Elite Chiropractic P.C. (“Elite Chiro”) is a Michigan professional corporation formed in 2011. Derek Bittner is the resident agent and sole officer.

         Bittner P.C. and Elite Chiro submitted bills to State Farm Mutual for chiropractic services purportedly rendered at four locations: Sterling Heights, Detroit, Westland, and Riverview. (Compl. at ¶ 205).

         Defendant Elite Rehabilitation, Inc. (“Elite Rehab”) is a Michigan domestic non-profit formed by Bittner in 2011. (Compl. at ¶ 206). Defendant Pure Rehabilitation, Inc., (“Pure Rehab”) is a Michigan domestic non-profit corporation formed in March 2014 to replace Elite Rehab. (Compl. at ¶ 207). Defendant Elite Health Centers, Inc., (“Elite Health”) is a Michigan domestic non-profit formed in 2011 by Bittner. (Compl. at ¶ 208).

         From 2013 through June 2014, Elite Health submitted documentation for: (1) physical therapy under the assumed names Rehabilitation of Sterling Heights and Rehabilitation of Detroit; (2) for medical exams under the name Pain Specialists of Michigan; (3) for surgery consultations under the name Prime Neurosurgery Group; and (4) for neurological consultations under the name Pioneer Neurology Group. Defendant Midwest Medical Associates, Inc. (“Midwest Medical”) is a Michigan domestic non-profit corporation formed in March 2014 to replace Elite Health.

         b. Defendant Chiropractors

         Defendant Ryan Matthew Lukowski, D.C. (“Lukowski”) is a licensed chiropractor. (Compl. at ¶ 211). From Approximately 2012 through approximately February 2013, Lukowski worked for the Elite Entities full-time at the Detroit location and once a week at the Sterling Heights location.

         Defendant Michael Patrick Draplin, D.C., (“Draplin”) is a licensed chiropractor. (Compl. at ¶ 212). Draplin worked for the Elite Entities at the Detroit location, where he became the primary Elite chiropractor after Lukowski left.

         State Farm alleges that Lukowski and Draplin: (1) falsely purported to provide legitimate chiropractic evaluations and treatment for a significant number of patients who were treated at Elite pursuant to the Predetermined Protocol; (2) referred patients to Elite doctors for medical exams pursuant to which medically unnecessary physical therapy could be prescribed; and (3) ordered medically unnecessary MRIs.

         c. The Elite Doctors

         Defendant Noah Upfall, D.O. (“Upfall”) is a licensed doctor of osteopathy. (Compl. at ¶ 213). Upfall worked for Elite Health and its successor, Midwest Medical, from 2011 through February 2014.

         Defendant Mark J. Juska, M.D. (“Juska”) is a licensed medical doctor. (Compl. at ¶ 214). Juska worked at Elite Health and its successor, Midwest Medical, from late 2013 through early 2015. Juska testified that: he was an employee of Michigan Sportsj and Spine Center, P.C. (“Michigan Sports”); his boss was Jeff S. Pierce, D.O., who is the president of Michigan Sports; Pierce arranged for him to work at Elite Health; there was a relationship or agreement between Elite Health and Michigan Sports; and that he was paid by Michigan sports, not Elite Health.

         Upfall and Juska are alleged to have falsely examined, diagnosed and prescribed medically unnecessary physical therapy for patients who treated at the Elite Entities and made referrals to other Elite doctors and ordered medically unnecessary MRIs.

         d. MRI Defendants (Defendant Desai)

         Defendant Superior Diagnostic, Inc. (“Superior”) is a Michigan non-profit corporation formed in 2014. (Compl. at ¶ 215). Superior is owned by Bittner and Radom, either directly or indirectly through Midwest Medical, which in turn is owned by Bittner and Radom.

         Bittner and Radom are alleged to have directed chiropractors, doctors and staff at the Elite Entities to steer patients to Superior for medically unnecessary MRIs to serve Radom's and Bittner's financial interests.

         Defendant Chintan Desai, M.D. is a licensed doctor and works as an independent contractor with a teleradiology company where he remotely reviews MRIs for non-party Horizon Imaging, LLC, a mobile MRI truck located in a parking lot (in which Radom allegedly has a financial interest). (Compl. ¶¶ 22, 216). Defendant Michael J. Paley, M.D. (“Paley”) is a licensed doctor and remotely reviews MRIs from non-party Horizon and Defendant Superior. (Compl. at ¶ 217).

         Desai and Paley allegedly provided fraudulent MRI reports for patients who treated at Elite, which report abnormalities that do not exist and which over-read and exaggerate abnormalities that may exist.

         e. The Rosett Defendants

         At all times relevant to this action, Defendant Jayson Rosett (“Rosett”) owned Defendant Dearborn Center for Physical Therapy, LLC (“Dearborn Center”) and Defendant Michigan Center for Physical Therapy, Inc. (“Michigan Center”) (collectively, “the Rosett PT Entities”). (Compl. at ¶ 219).

         Rosett is alleged to have directed the activities of those who were employed by and associated with the Rosett PT Entities. From 2011 to present, the Rosett PT Entities allegedly submitted medical records and supporting documents, which were fraudulent in that they represented that physical therapy services were actually rendered and were medically necessary when, in fact, they were not.

         2. Allegations Regarding ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.