Second Circuit Revives GEICO Reimbursement Refusal Case

The Second Circuit on Tuesday revived a case over whether an insurer in New York can refuse to reimburse a health care provider who illegally paid third-party non-medical professionals for patient referrals.

The court reversed a summary judgment decision in favor of GEICO, which had argued state regulations allow the insurer to refuse to pay licensed acupuncturist Igor Mayzenberg for services he provided to patients who were injured in car accidents.

The New York Court of Appeals in November ruled that insurers can’t refuse to pay a provider on the basis of alleged professional misconduct. That decision, stemming from a ...