TAMPA — Alleging a "massive fraud scheme" of kickbacks and patient brokering, insurance giant State Farm has filed a federal lawsuit against chiropractor Gary Kompothecras, his clinics and the 1-800-Ask-Gary doctor-lawyer referral service.
Potentially at stake: more than $19 million in no-fault medical claims State Farm reports it has paid since 2005 to the Physicians Group accident clinics Kompothecras founded.
State Farm asserts that a "substantial portion" of the charges were unlawful because they were rooted in a patient referral system that violates Florida laws, including the Patient Brokering Act, the Anti-Kickback Statute and the Patient Self-Referral Act.
So far, the insurer said it has identified at least $480,000 in such illegal claims. It is likely a "small subset," the lawsuit states, but efforts to investigate have been thwarted by records deletion and poor cooperation.
State Farm wants a judge to return the $480,000, nullify the clinics' pending bills and make the defendants' records available for further inspection.
The complaint describes a scheme to aggressively market post-crash medical care, whether or not motorists believe they are injured, and to exhaust the $10,000 limits of personal injury protection without regard to available health insurance. Physicians Group clinics accept only auto insurance.
No lawyers are named as defendants. However, State Farm attached to its lawsuit an affidavit from lawyer Anthony Gadlage, who stated that he lost his job at the Kentucky office of the now-defunct Winters & Yonker law firm because he refused to participate in a quid pro quo referral pact with Kompothecras, his clinics and 1-800-Ask-Gary.
Kompothecras, of Siesta Key, declined to comment. He referred the Tampa Bay Times to a statement released by attorney Gregory Zitani, which called the lawsuit "frivolous" and a "desperate act by State Farm."
State Farm owes Physicians Group $9 million, Zitani said, a majority from no-fault claims.
"State Farm will be exposed to claims for malicious prosecution by pursuing this absurd action to attempt to avoid paying the millions of dollars it owes to the defendants," Zitani said.
The 52-page complaint, filed Friday on behalf of State Farm Mutual Automobile Insurance Co. and State Farm Fire & Casualty Company, also seeks punitive damages.
It names Kompothecras, two associates, a management company, two Physicians Group companies and two entities the lawsuit characterizes as "shell companies" used to "facilitate the illusion that Ask Gary is an independent and legitimate medical and legal referral service."
"In fact it is secretly owned and controlled by Kompothecras and exists to unlawfully steer all unwitting callers to Kompothecras' own clinics, the Physicians Group Clinics, and to PI (personal injury) attorneys who pay fees to Ask Gary to obtain client referrals," the suit states.
The chiropractor's link to the name 1-800-Ask-Gary was never a well-kept secret, especially after it landed on an amphitheater at the Florida State Fairgrounds in 2010, part of a marketing campaign that featured a woman named "Roz" who told callers not to be scared and confused.
Kompothecras registered the name in 2005, the suit states. But in 2007, his cousin, William Sigelakis, filed state papers saying it was he who owned the referral company. In truth, the suit alleges, Sigelakis was a driver and delivery man — an owner in name only.
The statement released by Zitani said that all of the defendants, including Physicians Group and 1-800-Ask-Gary, comply with Florida and federal laws.
Attorneys who are part of the network "are not advised or required to refer any of their clients to the Physicians Group or any medical providers," the statement read. "This is a condition contained in the attorneys agreement with the Ask Gary network."
Patty Ryan can be reached at firstname.lastname@example.org or (813) 226-3382.