# Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C.

> District Court, E.D. New York · March 25, 2025

URL: https://www.frixlaw.com/law-library/cases/10830805

## Case

- **Court:** District Court, E.D. New York
- **Decided:** March 25, 2025
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/10830805

## How later opinions describe it (automated extraction)

- noting that the defendants will “benefit from the stay if [they] ultimately prevail[] in th[e] matter, because [they] will be entitled to the collection of interest”

## Opinion text

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF NEW YORK
---------------------------------------------------------------
GOVERNMENT EMPLOYEES INSURANCE
CO., GEICO INDEMNITY CO., GEICO
GENERAL INSURANCE COMPANY and GEICO
CASUALTY CO., MEMORANDUM & ORDER
24-CV-2220 (MKB)
Plaintiffs,

v.

INNOVATION ANESTHESIA & PAIN
SERVICES, P.C., DONGHUI CHEN, M.D., JPM
PHYSICAL THERAPY, P.C., SABINIANO
MANGGURAY, P.T., LIBERTY PARK
CHIROPRACTIC, P.C., JOSEPH CICCONE, D.C.,
HAO ACUPUNCTURE, P.C., and HONG ZHU
WU, L.Ac.,

Defendants.
---------------------------------------------------------------
MARGO K. BRODIE, United States District Judge:
Plaintiffs Government Employees Insurance Co., GEICO Indemnity Co., GEICO General
Insurance Company, and GEICO Casualty Co. (collectively, “GEICO” or “Plaintiffs”)
commenced the above-captioned action on March 26, 2024, against Defendants Innovation
Anesthesia & Pain Services, P.C. (“Innovation Anesthesia”); Donghui Chen, M.D. (“Chen”);
JPM Physical Therapy, P.C. (“JPM PT”); Sabiniano Mangguray, P.T. (“Mangguray”); Liberty
Park Chiropractic, P.C. (“Liberty Park Chiro”); Joseph Ciccone, D.C. (“Ciccone”); Hao
Acupuncture, P.C. (“Hao Acupuncture”); and Hong Zhu Wu, L.Ac (“Wu”). (Compl., Docket
Entry No. 1.) Plaintiffs allege, inter alia, that Defendants wrongfully obtained no-fault insurance
reimbursements for medically unnecessary healthcare services in violation of the Racketeer
Influenced and Corrupt Organizations Act, 18 U.S.C. §§ 1962(c)–(d) (“RICO”) and are liable for
common law fraud, aiding and abetting fraud, and unjust enrichment, (id. ¶¶ 1, 265–401), and
seek damages against all defendants, and a declaratory judgment against Innovation Anesthesia,
Liberty Park Chiro, Hao Acupuncture, and JPM PT, (id. ¶¶ 261–401).
On September 24, 2024, Plaintiffs moved to (1) stay, until resolution of litigation, all
pending no-fault insurance collection arbitrations and state court collections litigation

commenced against GEICO by or on behalf of Innovation Anesthesia, Chen, Liberty Park Chiro,
Mangguray, Ciccone, and JPM PT; and (2) enjoin all Defendants, until resolution of litigation,
from commencing any new no-fault insurance collection arbitrations or new no-fault collections
litigation against GEICO.1 Defendants opposed the motion.2 For the reasons set forth below, the
Court grants Plaintiffs’ motion to stay (1) all pending arbitrations, (2) all future arbitrations, (3)
all pending state court proceedings, and (4) all future state court proceedings.
I. Background
a. New York and New Jersey’s no-fault insurance scheme
Under New York’s no-fault law, automobile insurers provide mandatory coverage for
certain no-fault benefits, including necessary expenses for medical treatment up to $50,000.3

N.Y. Ins. Law §§ 5102(a)(1), 5102(b), 5103; see also State Farm Mut. Auto. Ins. Co. v. Tri-
Borough NY Med. Prac. P.C., 120 F.4th 59, 71 (2d Cir. 2024) (“The No-Fault Act provides
compensation for ‘basic economic loss,’ which covers, as relevant here, ‘necessary’ health

1 (Pls.’ Mot. to Stay (“Pls.’ Mot.”), Docket Entry No. 28-1; Pls.’ Mem. in Supp. of Pls.’
Mot. (“Pls.’ Mem.”), Docket Entry No. 28-2; Pls.’ Reply in Supp. of Pls.’ Mot. (“Pls.’ Reply”),
Docket Entry No. 28-19.)

2 (Defs.’ Response to Pls.’ Mot. (“Defs.’ Opp’n”), Docket Entry No. 28-4.)

3 Because it is helpful to understand the facts of the case, the Court provides a brief
overview of New York’s no-fault insurance scheme before discussing the relevant facts. See
generally Allstate Ins. Co. v. Elzanaty, 916 F. Supp. 2d 273, 281–83 (E.D.N.Y. 2013) (providing
a detailed overview of New York’s no-fault scheme).
expenses up to $50,000 per person.” (quoting N.Y. Ins. Law § 5102(a))). “The Act’s
implementing regulations allow covered individuals to assign their statutory benefits to licensed
health care providers in exchange for services, and the providers in turn can submit claims
directly to the insurance company for medically necessary expenses.” See id. (citing N.Y.
Comp. Codes R. & Regs. tit. 11, § 65-3.11(a)); United States v. Zemlyansky, 908 F.3d 1, 7 (2d

Cir. 2018) (“[I]ndividuals injured in car accidents assign their statutory benefits to licensed
medical professionals, who submit claims for medically ‘necessary’ treatments directly to the
injured party’s insurance carriers.” (first quoting N.Y. Ins. Law § 5102; and then citing N.Y.
Comp. Codes R. & Regs. tit. 11, § 65-3.11)). The regulation also states that “[i]n the event any
person making a claim for first-party benefits and the [insurance] [c]ompany do not agree
regarding any matter relating to the claim, such person shall have the option of submitting such
disagreement to arbitration.” N.Y. Comp. Codes R. & Regs. tit. 11, § 65-1.1(d); see State Farm,
120 F.4th at 87; Allstate Ins. Co. v. Mun, 751 F.3d 94, 87 (2d Cir. 2014) (quoting N.Y. Comp.
Codes R. & Regs. tit. 11, § 65-1.1).

“New Jersey also has a comprehensive no-fault regime.” Gov’t Emps. Ins. Co. v.
Mahmood, No. 23-CV-4388, 2024 WL 113958, at *2 (E.D.N.Y. Jan. 10, 2024); see, e.g., the
Compulsory Insurance Law (N.J. Stat. Ann. §§ 39:6B-1–39:6B-3; Citizens United Reciprocal
Exch. v. Perez, 121 A.3d 374, 379 (N.J. 2015)) and the New Jersey Automobile Reparation
Reform Act (N.J. Stat. Ann. §§ 36A-1–36A-35). Claimants may “assign[]” their no-fault claims
“to healthcare service providers.” Gov’t Emps. Ins. Co. v. Beynin, No. 19-CV-6118, 2021 WL
1146051, at *2 n.1 (E.D.N.Y. Mar. 25, 2021). New Jersey’s no-fault regime includes an
arbitration statute which allows for arbitration of disputes concerning “medical expense benefits”
including “whether the disputed medical treatment was actually performed,” the “necessity . . . of
consultations by other healthcare providers,” and “whether the treatment performed is
reasonable, necessary, and compatible with the protocols provided.” N.J. Stat. Ann. § 39:6A-5.1.
New Jersey’s no-fault laws also include the New Jersey Insurance Fraud Prevention Act
(“IFPA”) under which plaintiffs may instead bring an action relating to fraudulent insurance
claims in state or federal court. See N.J. Stat Ann. §§ 17:33A-1–17:33A-34. A person violates

the IFPA if he or she “[p]resents or causes to be presented any written or oral statement as part
of, or in support of or opposition to, a claim for payment or other benefit pursuant to an
insurance policy . . . knowing that the statement contains any false or misleading information
concerning any fact or thing material to the claim.” Id. § 17:33A-4(a)(1). “Although New
Jersey generally requires arbitration for no-fault insurance claims, New Jersey courts have
repeatedly found that claims under the IFPA may be heard in state or federal courts.” Gov’t
Emps. Ins. Co. v. Gerling, 718 F. Supp. 3d 268, 271 (E.D.N.Y. 2024); see Gov’t Emps. Ins. Co.
v. Elkholy, No. 21-16255, 2022 WL 2373917, at *9–10 (D.N.J. June 30, 2022) (“[C]ourts
routinely uphold the IFPA’s absolute mandate for judicial resolution notwithstanding contractual

clauses that would otherwise require arbitration of IFPA claims.” (first citing Nationwide Mut.
Fire Ins. Co. v. Fiouris, 928 A.2d 154, 157 (N.J. Super. Ct. App. Div. 2007); and then citing
Fed. Ins. Co. v. von Windherburg-Cordeiro, No. 12-CV-2491, 2012 WL 6761877, at *4 (D.N.J.
Dec. 31, 2012))); Citizens United Reciprocal Exch. v. Meer, 321 F. Supp. 3d 479, 492 (D.N.J.
2018) (“The [IFPA] is not preempted by [no-fault] arbitration rules.”).
b. The parties
Government Employees Insurance Company, GEICO Indemnity Company, GEICO
General Insurance Company, and GEICO Casualty Company “are Nebraska corporations with
their principal places of business in Chevy Case, Maryland.” (Compl. ¶ 7.) “GEICO is
authorized to conduct business and to issue automobile insurance policies in New York and New
Jersey.” (Id.) “GEICO underwrites automobile insurance in New York and New Jersey.” (Id. ¶
22.)
Chen is a citizen of New York, and was licensed to practice medicine in New York on or
about May 6, 2004, and in New Jersey on or about June 7, 2004. (Id. ¶ 9.) Plaintiffs contend
that Chen “owned and controlled Innovation Anesthesia, purported to perform virtually all of the

[f]raudulent [s]ervices,” and “used Innovation Anesthesia as a vehicle to submit fraudulent and
unlawful no-fault insurance billing to GEICO. . . .” (Id.) “Innovation Anesthesia is a New York
medical professional corporation with its principal place of business in New York.” (Id. ¶ 8.)
Mangguray is a citizen of New York, and “was licensed to practice physical therapy in
New York on or about May 27, 2009.” (Id. ¶ 11.) Plaintiffs contend that Mangguray “owned
and controlled JPM PT, purported to perform many of the [f]raudulent [s]ervices,” and “used
JPM PT as a vehicle to submit fraudulent and unlawful no-fault insurance billing to GEICO. . . .”
(Id.) “JPM PT is a New York physical therapy professional corporation with its principal place
of business in New York.” (Id. ¶ 10.)

Ciccone is a citizen of New York, and “was licensed to practice chiropractic in New York
on or about August 6, 1999.” (Id. ¶ 13.) Plaintiffs contend that Ciccone “owned and controlled
Liberty Park Chiro, purported to perform many of the [f]raudulent [s]ervices,” and “used Liberty
Park Chiro as a vehicle to submit fraudulent and unlawful no-fault insurance billing to GEICO. .
. .” (Id.) “Liberty Park Chiro is a New York chiropractic professional corporation with its
principal place of business in New York.” (Id. ¶ 12.)
Wu is a citizen of New York, and “was licensed to practice acupuncture in New York on
or about February 14, 2001.” (Id. ¶ 15.) Plaintiffs contend that Wu “owned and controlled Hao
Acupuncture, purported to perform many of the [f]raudulent [s]ervices,” and “used Hao
Acupuncture as a vehicle to submit fraudulent and unlawful no-fault insurance billing to GEICO.
. . .” (Id.) “Hao Acupuncture is a New York acupuncture professional corporation with its
principal place of business in New York.” (Id. ¶ 14.)
c. The alleged fraudulent scheme
Plaintiffs contend that “Defendants wrongfully obtained from GEICO by submitting, and

causing to be submitted, thousands of fraudulent and unlawful no-fault insurance charges”
through Innovation Anesthesia, JPM PT, Liberty Park Chiro, and Hao Acupuncture “for
purported examinations, pain management injections, radiofrequency nerve ablations,
epidurography, fluoroscopic guidance, acupuncture, chiropractic, physical therapy, and related
services.” (Id. ¶ 1.) In particular, Plaintiffs allege that “Defendants engaged in an unlawful
patient brokering scheme whereby they paid and received unlawful compensation in exchange
for patient referrals” in addition to “misrepresent[ing] the nature, extent, results, and medical
necessity of the healthcare services they purported to provide, and falsely represent[ing] that they
were in compliance with relevant law and eligible to receive no-fault insurance reimbursement in
the first place, when in fact they were not.” (Id. ¶ 2.)

“Beginning no later than 2018,” Defendants enacted an “unlawful scheme” in which they
caused “fraudulent . . . [statutory no-fault] billing to be submitted to GEICO for medically
unnecessary, illusory, unlawful, and otherwise non-reimbursable services in New York and New
Jersey.” (Id. ¶ 46.) Plaintiffs contend that Defendants’ unlawful scheme comprised four main
components: (1) Innovation Anesthesia’s unlawful provision of professional services in New
Jersey, (id. ¶¶ 47–53); (2) Defendants’ agreements among themselves to refer patients for
unnecessary medical services in exchange for unlawful compensation, (id. ¶¶ 54–78); (3)
Defendants’ provision of medically unnecessary treatments and submission of fraudulent charges
for those services, (id. ¶¶ 79–252); and (4) Defendants’ fraudulent concealment of their billing
practices, (id. ¶¶ 253–60).
i. Innovation Anesthesia’s New Jersey operations
Plaintiffs allege that because Innovation Anesthesia was only a New York corporation,
they “could not lawfully provide medical or other professional services in the state of New

Jersey.” (Id. ¶¶ 48–49.) However, Plaintiffs contend that Chen “routinely caused Innovation
Anesthesia to unlawfully provide purported medical services in New Jersey, which then were
billed to GEICO.” (Id. ¶ 50.) Plaintiffs allege that Innovation Anesthesia and Chen submitted
more than $100,000 in billing to GEICO “for services unlawfully provided — to the extent they
were provided at all — through Innovation Anesthesia in New Jersey.” (Id. ¶ 52.)
ii. Defendants’ referral and payment scheme
Plaintiffs allege that Defendants had “secret agreements” to refer insureds to Innovation
Anesthesia “for expensive and medically unnecessary interventional pain management services,
despite the [i]nsured’s lack of any genuine presenting problems that would warrant the
examinations and injections.” (Id. ¶ 59.) JPM PT, Mangguray, Liberty Park Chiro, Ciccone,
Hao Acupuncture, and Wu referred patients to Innovation Anesthesia and Chen

“for expensive and medically unnecessary/excessive examinations and interventional pain
management services, despite the [i]nsureds’ lack of any genuine presenting problems that would
warrant those services.” (collectively, the “Referring Defendants”). (Id. ¶¶ 55–58, 239.)
Plaintiffs contend that these initial referrals were not medically necessary. First, they argue that
Referring Defendants often referred patients who “had yet to fail a legitimate course of
conservative treatment.” (Id. ¶¶ 68–72.) Plaintiffs note that “[i]n a legitimate clinical setting,
referrals for pain management services generally will be improper unless the patient has failed” a
more conservative treatment. (Id. ¶ 69.) However, Innovation Anesthesia and Chen “pursuant to
their unlawful referral scheme, often received medically unnecessary pain management referrals
from the Referring Defendnats long before the patients failed a legitimate course of conservative
treatment.” (Id. ¶ 70.) Second, Plaintiffs contend that Defendants provided “differently
situated” patients, i.e., patients who “were different ages, in different physical conditions,” who
“suffered from different injuries, to the extent they suffered any injuries at all,” who “did not

require . . . referrals in the first instance,” with the same course of “[f]raudulent” treatment. (Id.
¶¶ 77–78.) For example, the Referring Defendants referred multiple insureds who had been
involved in the same underlying minor accident to Innovation Anesthesia and Chen for services
“on or about the same date, despite the fact that the [i]nsureds were differently situated.” (Id. ¶
73.) Plaintiffs allege that it is “highly improbable” that “any two or more [i]nsureds” involved in
minor accidents would “suffer substantially similar injuries” or “require a substantially similar
course of treatment,” and that it is nearly impossible that this pattern would occur “on many
occasions.” (Id. ¶¶ 74–76; see also ¶¶ 150–52.)
Innovation Anesthesia and Chen, in turn, unlawfully compensated the Referring

Defendants through (1) payments for initial referrals disguised as rent payments for Innovation
Anesthesia and Chen’s use of the Referring Defendants’ offices,4 and (2) “return referrals” to the
Referring Defendants from Innovation Anesthesia and Chen for additional medically
unnecessary services. (Id. ¶ 61.) Plaintiffs contend that the purported rent payments Innovation
Anesthesia and Chen made to the Referring Defendants “were not for fixed fees set in advance,
and did not cover any regular lease terms,” (id. ¶ 65). Plaintiffs contend that the Referring
Defendants’ offices “did not contain any external signage or other indicia of Innovation

4 The offices are located at 93-16 Liberty Avenue, Ozone Park, New York. (Compl. ¶
61.)
Anesthesia and Chen” operating from the offices, and further contend that Innovation Anesthesia
and Chen “did not maintain regular office hours” and instead appeared “sporadically” only to
treat “patients who were referred to them by the Referring Defendants” pursuant to the scheme.
(Id. ¶¶ 64–66.)
In addition, Plaintiffs allege that the Referring Defendants engaged in a return referral

scheme, where Innovation Anesthesia and Chen would refer the insureds back to the Referring
Defendants for additional treatment as “unlawful compensation to the Referring Defendants for
their initial referrals of [i]nsureds to Innovation Anesthesia and Chen. (Id. ¶ 67.) They allege
Innovation Anesthesia and Chen made “false contentions” through the return referrals “that
[i]nsureds continued to suffer from significant levels of pain, functional deficits, and
radiculopathies” to provide both a “false justification for the medically unnecessary [services]
that [Referring Defendants] already had provided” as well as a “false justification for the
Referring Defendants to continue to provide medically unnecessary chiropractic, physical
therapy, and acupuncture services.” (Id. ¶¶ 67, 239.)

iii. Defendants’ submission of fraudulent charges and provision of
medically unnecessary treatments
Plaintiffs allege that Defendants submitted fraudulent charges for a wide variety of
treatments. Plaintiffs allege that Innovation Anesthesia, Chen, Liberty Park Chiro, Ciccone, Hao
Acupuncture, and Wu submitted fraudulent charges for conducting “initial examinations” and
“follow-up examinations.” (Id. ¶¶ 79–86; 169–74.) Plaintiffs contend that “as a result of the
fraudulent and unlawful scheme,” Innovation Anesthesia, Chen, Liberty Park Chiro, Ciccone,
Hao Acupuncture, and Wu were not “in compliance with all significant laws and regulations or
licensing laws governing healthcare practice” and thus ineligible to submit claims for the initial
or follow-up examinations. (Id. ¶ 85.) In addition, Defendants also “misrepresented the extent,
nature, and results” of the examinations, (id. ¶¶ 86, 174), and, in extreme cases, whether “the
putative initial examinations were conducted in the first instance,” (id. ¶¶ 157–68). Plaintiffs
also allege Innovation Anesthesia and Chen falsely represented that they conducted
“consultations” rather than “examinations,” because “such consultations were reimbursable at a
higher rate than commensurate, ordinary patient examinations.” (Id. ¶ 91.) In addition, Plaintiffs

allege Defendants artificially inflated their claims for reimbursement by misrepresenting: (1) the
severity of insureds’ “presenting problems” at initial and follow-up examinations “in order to
create a false basis for the laundry list of other [f]raudulent [s]ervices that the Defendants
purported to provide to the [i]nsureds,” (id. ¶¶ 92–102, 175–86); (2) the time Defendants spent
with patients during examinations because examinations that require more time “are
reimbursable at a higher rate than examinations that require less time to perform,” (id. ¶¶ 103–
15); (3) the extent of physical examinations because more detailed physical examinations are
reimbursable at higher rates, (id. ¶¶ 116–28); (4) the complexity of the case or extent of medical
decision-making involved because examinations requiring “complex medical decision-making”

are reimbursable at higher rates, (id. ¶¶ 129–56); and (5) the results of follow-up examinations
where Defendants claimed “[i]nsureds continued to suffer pain and other symptoms” so that
Defendants could provide “a false basis for the laundry list of other [f]raudulent [s]ervices,” (id.
¶¶ 187–93).
Plaintiffs further allege that Defendants provided inappropriate and medically
unnecessary treatments to insureds. First, Plaintiffs argue Innovation Anesthesia and Chen
subjected “many [i]nsureds to a series of medically unnecessary pain management injections” as
part of the “false, boilerplate ‘diagnoses’” they provided during their “fraudulent examinations.”
(Id. ¶¶ 194–211.) For example, Plaintiffs describe that “in order to maximize the fraudulent
billing,” Innovation Anesthesia and Chen provided “multiple pain management injections — and
multiple varieties of pain management injections — to [i]nsureds within a span of weeks,”
placing insureds “at considerable risk.” (Id. ¶ 208.) Second, Plaintiffs contend that Defendants
“routinely and fraudulently unbundled separate charges for fluorosciopic guidance from the
underlying injection charges, in a calculated effort to increase their billing for the medically

unnecessary injections.” (Id. ¶¶ 212–26.) Plaintiffs note that “fluoroscopic guidance is a
component part of, and included in, charges for pain management injections,” and healthcare
services providers are thus “not entitled to be reimbursed separately for fluoroscopic guidance . .
. when billing for pain management injections.” (Id. ¶¶ 214–15.) In addition, Plaintiffs contend
that Innovation Anesthesia and Chen “frequently submitted separate charges for epiduorgraphy
that supposedly was necessary to perform the injections,” even though fluoroscopic guidance is
included in the epidurography charges, and healthcare services providers are not entitled to bill
separately for fluoroscopic guidance and epidurography. (Id. ¶¶ 219–24.) Third, Plaintiffs
allege that Innovation Anesthesia and Chen provided medically unnecessary radiofrequency

nerve ablation (“RFA”). (Id. ¶¶ 227–35.) Plaintiffs contend that Defendants’ treatment of
insureds’ injuries with RFA services, “months after the underlying accidents, [and therefore]
long after the [i]nsureds’ minor soft tissue injuries resolved,” served to “damage or destroy . . .
nerve endings” in the spines of insureds that are “responsible for transmitting pain signals to the
patient.” (Id. ¶¶ 233–35.) Fourth, Plaintiffs contend Defendants submitted claims for
chiropractic, physical therapy, and acupuncture services that were “medically unnecessary” and
performed, if at all, “pursuant to the Defendants’ pre-determined treatment protocol in order to
maximize the potential charges they could submit to [Plaintiffs].” (Id. ¶ 243.)
Plaintiffs allege that Defendants’ submission of bills and treatments reports thus
contained “thousands of fraudulent charges, seeking payment for the [f]raudulent [s]ervices for
which they were not entitled to receive payment.” (Id. ¶ 251.) They contend that the “bills and
treatment reports were false and misleading” because they (1) “uniformly misrepresented to
GEICO that the Defendants were in compliance with all significant statutory and regulatory
requirements governing healthcare practice and/or licensing laws”; (2) “uniformly

misrepresented to GEICO that the [f]raudulent [s]ervices were provided in compliance with all
significant statutory and regulatory requirements”; (3) “uniformly misrepresented to GEICO that
the [f]raudulent [s]ervices were medically necessary, and, in many cases, misrepresented to
GEICO that the [f]raudulent [s]ervices actually were performed in the first instance”; and (4)
“misrepresented and exaggerated the level of the [f]raudulent [s]ervices, the nature of the
[f]raudulent [s]ervices that purportedly were provided, and the reimbursable amounts for the
[f]raudulent [s]ervices.” (Id. ¶ 252.)
iv. Defendants’ fraudulent concealment of their billing practices
Plaintiffs allege that Defendants “systemically concealed their fraud” to induce GEICO
“to promptly pay the fraudulent charges for the [f]raudulent [s]ervices.” (Id. ¶ 254.) They

contend that Defendants “knowingly misrepresented and concealed facts” to prevent GEICO
from discovering that Defendants either never performed services for which they sought
reimbursement or that services they did perform were conducted “pursuant to an illegal referral
scheme.” (Id. ¶¶ 256–57.) Plaintiffs allege that as a part of Defendants’ scheme, they “hired law
firms to pursue collection of the fraudulent charges from GEICO and other insurers.” (Id. ¶
258.) The law firms routinely filed “expensive and time-consuming arbitrations” against GEICO
if the charges were not paid in full. (Id.) Defendants currently have 760 arbitrations and more
than 200 individual lawsuits in New York state court pending against Plaintiffs. (Pls.’ Mem. 7.)
In the month following the filing of the Complaint in this case, Innovation Anesthesia, JPM PT,
and Liberty Park Chiro initiated over 500 suits and arbitrations against GEICO, and Defendants
are “actively pursuing collection” on fraudulent charges. (Id. at 4–5.) Plaintiffs note that
Defendants’ “facially-valid documents submitted to GEICO in support of the fraudulent charges”
were “designed to and did cause GEICO to rely upon them” in complying with their “statutory
and contractual obligations to promptly and fairly process claims.” (Compl. ¶¶ 253, 259.) They

allege that, as a result of Defendants’ “material misrepresentations, omissions, and other
affirmative acts to conceal their fraud,” GEICO has incurred damages of more than $6,300,000
and that they “could not reasonably have discovered that its damages were attributable to fraud
until shortly before” filing this case. (Id. ¶¶ 259–60.)
II. Discussion
a. Standard of review
“The preliminary injunction standard applies where . . . a party seeks to stay pending no-
fault insurance claims and to enjoin the filing of further claims during the pendency of a lawsuit
seeking to invalidate those claims.” Beynin, 2021 WL 1146051, at *4 (collecting cases); see also
Gov’t Emps. Ins. Co. v. Wellmart, Inc., 435 F. Supp. 3d 443, 449 (E.D.N.Y. 2020) (analyzing a

motion to stay and enjoin no-fault collection proceedings under the preliminary injunction
standard), appeal dismissed, No. 20-225 (2d Cir. May 11, 2020). “[A] preliminary injunction is
‘an extraordinary remedy never awarded as of right.’” Benisek v. Lamone, 585 U.S. 155, 158
(2018) (per curiam) (quoting Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 24 (2008)); see
also State Farm, 120 F.4th at 79 (“A preliminary injunction ‘is an extraordinary and drastic
remedy, one that should not be granted unless the movant, by a clear showing, carries the burden
of persuasion.’” (quoting Moore v. Consol. Edison Co. of N.Y., 409 F.3d 506, 510 (2d Cir.
2005))); Woodstock Ventures, LC v. Woodstock Roots LLC, 837 F. App’x 837, 838 (2d Cir.
2021) (same). The purpose of a preliminary injunction is to “preserve the relative positions of
the parties until a trial on the merits can be held.” Benisek, 585 U.S. at 161 (quoting Univ. of
Tex. v. Camenisch, 451 U.S. 390, 395 (1981)). A party seeking a preliminary injunction “must
establish (1) that it is likely to succeed on the merits, (2) that it is likely to suffer irreparable harm
if the injunction is not granted, (3) that the balance of the equities tips in its favor, and (4) that
the injunction serves the public interest.” SAM Party of N.Y. v. Kosinski, 987 F.3d 267, 273–74

(2d Cir. 2021); see also State Farm, 120 F.4th at 79 (noting that “to obtain a preliminary
injunction,” the movant “must show ‘(1) irreparable harm; (2) either a likelihood of success on
the merits or both serious questions on the merits and a balance of hardships decidedly favoring
the moving party; and (3) that a preliminary injunction is in the public interest.’” (quoting N.
Am. Soccer League, LLC v. U.S. Soccer Fed’n, 883 F.3d 32, 37 (2d Cir. 2018))).
b. The Anti-Injunction Act
As an initial matter the Court first determines whether the Anti-Injunction Act (“AIA”)
limits the Court’s authority to stay Defendants’ pending proceedings in state court.5 The parties
dispute whether any exceptions to the AIA apply to Plaintiffs’ request that the Court stay these
pending state court collections actions. Plaintiffs argue that the AIA “expressly allows a federal

court to stay such pending proceedings ‘where necessary in aid of its jurisdiction, or to protect or
effectuate its judgment.’”6 (Pls.’ Mem. 20 (quoting 28 U.S.C. § 2283).) Defendants argue that

5 Defendants do not argue that the Federal Arbitration Act applies to limit the Court’s
authority to enjoin pending or future arbitrations. (See generally Defs.’ Opp’n.) Therefore, the
Court’s analysis is limited to whether the Anti-Injunction Act bars the Court from enjoining
Defendants’ pending state-court actions.

6 Plaintiffs argue that several courts in the Eastern District “have routinely stayed . . . all
state court collections lawsuits pending against an insurer in virtually identical circumstances —
each citing to the ‘in aid of its jurisdiction’ exception of the AIA.’” (Pls.’ Mem. 20 (citing Gov’t
Emps. Ins. Co. v. Wallegood, Inc., No. 21-CV-1986 (E.D.N.Y. July 16, 2021) (order granting
preliminary injunction)); Pls.’ Reply 9 (citing Gov’t Emps. Ins. Co. v. Gerling, 718 F. Supp. 3d
268 (E.D.N.Y. 2024); Gov’t Emps. Ins. Co. v. Patel, No. 23-CV-2835, 2024 WL 84139
the “expressly-authorized exception” to the AIA “does not apply to Plaintiffs’ request for a
preliminary injunction,” (Defs.’ Mem. 14 (citation omitted)), and, even if the AIA did apply to
Plaintiffs’ request, Plaintiffs “cannot satisfy the ‘necessary in aid’ of the court’s jurisdiction
exception to the Act.” (Defs.’ Mem. 14 (citing Gov’t Emps. Ins. Co. v. Mayzenberg, No. 17-CV-
2802, 2018 WL 6031156, at *9 (E.D.N.Y. Nov. 16, 2018)).)

“Almost as old as the Constitution, the AIA today provides that ‘[a] court of the United
States may not grant an injunction to stay proceedings in a State court except as expressly
authorized by Act of Congress, or where necessary in aid of its jurisdiction, or to protect or
effectuate its judgments.’” State Farm, 120 F.4th at 92 (alteration in original) (quoting 28
U.S.C. § 2283); see also Pathways, Inc. v. Dunne, 329 F.3d 108, 113 (2d Cir. 2003) (“The Anti-
Injunction Act, subject to some exceptions, prohibits injunctive relief that would interfere,
directly or indirectly, with pending state proceedings.” (citing County of Imperial v. Munoz, 449
U.S. 54, 58–59 (1980))). “Application of the AIA is limited only by the ‘three specifically
defined exceptions’ in the statute that are ‘narrow,’ so ‘[a]ny doubts as to the propriety of a

federal injunction against state court proceedings should be resolved in favor of permitting the
state courts to proceed.’” State Farm, 120 F.4th at 92 (alteration in original) (quoting Smith v.

(E.D.N.Y. Jan. 8, 2024); State Farm Mut. Auto. Ins. Co. v. Herschel Kotkes, No. 22-CV-3611,
2023 WL 4532460 (E.D.N.Y. July 13, 2023); Gov’t Emps. Ins. Co. v. Landow, No. 21-CV-1440,
2022 WL 939717 (E.D.N.Y. Mar. 29, 2022); Gov’t Emps. Ins. Co. v. Big Apple Med., No. 20-
CV-5786 (E.D.N.Y. Mar. 25, 2021) (order granting motion to stay and enjoin); State Farm Mut.
Auto. Ins. Co. v. Parisien, 352 F. Supp. 3d 215, 229 (E.D.N.Y. 2018); State Farm Mut. Auto. Ins.
Co. v. Jamaica Wellness Med., P.C., No. 16-CV-4948 (E.D.N.Y. May 18, 2017) (Min. Entry
dated May 18, 2017).) Plaintiffs also argue that “an injunction staying [pending collections]
lawsuits until this action is resolved is absolutely necessary to aid the jurisdiction of this Court,
prevent fragmented results, and avoid a drain of resources for all parties involved.” (Pls.’ Reply
9.) In addition, Plaintiffs argue that “an injunction ‘enjoining the state actions in this case is
consistent with the purpose of the AIA, which is rooted in respect for the sovereignty of state
governments over matters within their jurisdiction.’” (Pls.’ Mem. 22 (quoting Parisien, 352 F.
Supp 3d at 231).)
Bayer Corp., 564 U.S. 299, 306 (2011)); see also Dr.’s Assocs., LLC v. Tripathi, 794 F. App’x
91, 93 (2d Cir. 2019) (explaining that the Anti-Injunction Act contains three exceptions: it “bars
a federal court from enjoining a proceeding in state court unless that action is ‘expressly
authorized by Act of Congress, or where necessary in aid of its jurisdiction, or to protect or
effectuate its judgments’”).7 “The AIA reflects our ‘dual system of federal and state courts,’ and

its ‘core message is one of respect for state courts.’” State Farm, 120 F.4th at 92 (quoting Smith,
564 U.S. at 306).
Because the statutory prohibition against such injunctions in part “rests on the
fundamental constitutional independence of the [s]tates and their courts, the exceptions should
not be enlarged by loose statutory construction.” United States v. Schurkman, 728 F.3d 129, 135
(2d Cir. 2013) (quoting Atl. Coast Line R.R. Co. v. Brotherhood of Locomotive Eng’rs, 398 U.S.
281, 287 (1970)); In re Payment Card Interchange Fee & Merchant Discount Antitrust Litig.,
348 F.R.D. 151, 169 (E.D.N.Y. 2024) (same).
“[T]he first exception to the AIA allows federal courts to enjoin state-court proceedings

when ‘expressly authorized by Act of Congress.’” State Farm, 120 F.4th at 92 (quoting 28
U.S.C. § 2283). In order “for the exception to apply, ‘Congress must have created a specific and
uniquely federal right or remedy, enforceable in a federal court of equity, that could be frustrated
if the federal court were not empowered to enjoin a state court proceeding.’” Id. at 93 (quoting
Mitchum v. Foster, 407 U.S. 225, 237 (1972)). As the Second Circuit recently reiterated, “the
Supreme Court held in the seminal case of Mitchum v. Foster that ‘no prescribed formula is

7 28 U.S.C. § 2283 provides, in full, that “[a] court of the United States may not grant an
injunction to stay proceedings in a [s]tate court except as expressly authorized by Act of
Congress, or where necessary in aid of its jurisdiction, or to protect or effectuate its judgments.”
required’ for the exception to apply, and that the federal statute ‘need not expressly refer to
§ 2283’ nor ‘expressly authorize an injunction of a state court proceeding in order to qualify as
an exception.’” Id. (internal quotation marks omitted) (quoting Mitchum, 407 U.S. at 237).
“Mitchum accordingly created a two-part test providing that the ‘expressly-authorized’ exception
to the AIA applies if Congress [1] clearly creat[ed] a federal right or remedy enforceable in a

federal court of equity, [2] [that] could be given its intended scope only by the stay of a state
court proceeding.” Id. (internal quotation marks omitted and alterations in original) (quoting
Mitchum, 407 U.S. at 238). In Mitchum, the Supreme Court found that “a federal law need not
expressly authorize an injunction of a state court proceeding in order to qualify as an exception,”
but “an Act of Congress must have created a specific and uniquely federal right or remedy,
enforceable in a federal court of equity, that could be frustrated if the federal court were not
empowered to enjoin a state court proceeding.” 407 U.S. at 237; see Vendo Co. v. Lektro-Vend
Corp., 433 U.S. 623, 632 (1977) (explaining that for the “expressly authorized” exception to
apply, the statute (1) “must have created a specific and uniquely federal right or remedy,

enforceable in a federal court of equity” and (2) it must be an “Act of Congress” which “could be
given its intended scope only by the stay of a state court proceeding” (quoting Mitchum, 407
U.S. at 237–38)); Texaco, Inc. v. Pennzoil Co., 626 F. Supp. 250, 259 (S.D.N.Y. 1986) (same),
aff’d as modified and remanded, 784 F.2d 1133 (2d Cir. 1986), rev’d on other grounds, 481 U.S.
1 (1987). An Act of Congress is not required to be “totally incompatible with the prohibition of
the anti-injunction statute” to qualify under the exception. Mitchum, 407 U.S. at 237–38. “The
test, rather, is whether an Act of Congress, clearly creating a federal right or remedy enforceable
in a federal court of equity, could be given its intended scope only by the stay of a state court
proceeding.” Id. at 238; see Sierra v. City of New York, 528 F. Supp. 2d 465, 468 (S.D.N.Y.
2008) (same). In State Farm, the Second Circuit concluded that RICO satisfies the two-part test
the Supreme Court articulated in Mitchum and Vendo. 120 F.4th at 95. First, RICO is “a
specific and uniquely federal right or remedy, enforceable in a federal court of equity.” Id.
(quoting Mitchum, 407 U.S. at 237). The Second Circuit explained that “RICO was specifically
‘designed to remedy injury caused by a pattern of racketeering, and concepts such as RICO

“enterprise” and “pattern of racketeering activity” were simply unknown to common law.’” Id.
(quoting Agency Holding Corp. v. Malley-Duff & Assocs., Inc., 483 U.S. 143, 149–50 (1987)).
Thus, “RICO creates a uniquely innovative federal remedy that did not exist at common law.”
Id. at 96. In addition, the Second Circuit found that RICO is similar to statutes the Supreme
Court evaluated in Mitchum and Vendo and concluded were “specific and uniquely federal
right[s] or remed[ies].” Id. at 97 (“Importantly, RICO’s legislative history demonstrates that
Congress modeled civil RICO on the Clayton Act, which all the Justices in Vendo agreed was a
specific and uniquely federal right or remedy.” (citation omitted)); id. (“RICO’s legislative
history reveals that in adopting the RICO statute, Congress was animated by concerns similar to

those underlying 42 U.S.C. § 1983 that Mitchum found persuasive.”). Second, “RICO could be
given its intended scope only by a stay of the hundreds of pending state-court proceedings.” Id.
As the Supreme Court concluded in Vendo, “where multiple meritless proceedings are a part of a
scheme to violate the relevant federal law in order to give that law its intended scope, an
injunction of state-court proceedings could fall within the ‘expressly-authorized’ exception.” Id.
The Second Circuit explained that because the plaintiffs “allege[] that the hundreds of frivolous
state-court proceedings themselves help to further the RICO violation,” the “unusual
circumstances here fall squarely within Vendo.” Id. at 98. The Second Circuit further explained
that the state-court proceedings in State Farm “furthered the alleg[ed] RICO violation in two key
ways”: (1) “the proceedings help[ed to] finance the purported scheme,” and (2) the “piecemeal
nature” of the state-court proceedings, which often concerned the claims of a single individual,
obscured the defendants’ “overall complex scheme.” Id. The Second Circuit noted that “[i]f the
pending state-court proceedings are allowed to continue, [the plaintiff] faces the irreparable harm
of never having a forum to demonstrate the existence of Defendants’ alleged RICO scheme.” Id.

Accordingly, “the only way to give RICO its intended scope in the specific circumstances here is
by staying the pending state-court proceedings.” Id. The Second Circuit emphasized that its
decision was “narrow and limited to the unusual circumstances alleged [in State Farm], which
involve a massive scheme including hundreds of purportedly meritless state-court proceedings
that help further a RICO violation.” Id. at 98–99.
Plaintiffs’ claims implicate identical “unusual circumstance[s]” the Second Circuit
identified in State Farm. Id. at 99. First, Plaintiffs in this case allege RICO violations, which is
the exact statute the Second Circuit concluded was a “specific and uniquely federal right or
remedy.” Id. at 95 (quoting Mitchum, 407 U.S. at 237). Plaintiffs’ claims thus implicate

uniquely federal rights or remedies and therefore satisfy the first prong of the Mitchum test. See
id. at 95–96 (“RICO’s legislative history demonstrates that Congress modeled civil RICO on the
Clayton Act, which all the Justices in Vendo agreed was a specific and uniquely federal right or
remedy.” (citation omitted)); Vendo, 433 U.S. at 632 (“The private action for damages conferred
by the Clayton Act is a ‘uniquely federal right or remedy,’ in that actions based upon it may be
brought only in the federal courts. It thus meets the first part of the test laid down in the
language quoted from Mitchum.” (citation omitted)); Armstrong v. Real Est. Int’l, Ltd., No. 05-
CV-5383, 2006 WL 354983, at *3 (E.D.N.Y. Feb. 14, 2006) (“To qualify for the first exception
to the Anti-Injunction Act, the equitable remedy . . . must be a uniquely federal one that could
only be enforceable in federal court.”). Second, as in State Farm, Plaintiffs allege Defendants
“hired law firms to pursue collection of the fraudulent charges from GEICO and other insurers,”
amounting to over 1,000 combined state-court lawsuits and arbitrations against Plaintiffs. (Id. ¶
258; Pl.’s Mem. 4–7.) Defendants’ expensive and time-consuming lawsuits “themselves help to
further the RICO violation” because, as in State Farm, their lawsuits enable Defendants to use

the benefits obtained from those lawsuits “to continue financing their scheme, thereby
constituting a ‘pattern of baseless, repetitive claims.’” State Farm, 120 F.4th at 98 (quoting
Vendo, 433 U.S. at 644). Plaintiffs’ claims therefore satisfy the second prong of Mitchum
because the Defendants’ “meritless proceedings are a part of a scheme to violate the relevant
federal law.” State Farm, 120 F.4th at 97 (“RICO could be given its intended scope only by a
stay of the hundreds of pending state-court proceedings here” because “where multiple meritless
proceedings are a part of a scheme to violate the relevant federal law in order to give that law its
intended scope, an injunction of state court proceedings could fall within the ‘expressly-
authorized exception.’”)

Accordingly, the Court finds that the expressly-authorized exception to the AIA applies
to Plaintiffs’ request for a preliminary injunction of pending no-fault insurance state court
proceedings.
c. Preliminary injunction
Plaintiffs argue that the Court should enjoin pending and future state court litigation and
pending and future arbitrations, and argue in support that district courts within the Second
Circuit have “consistently” granted “substantially similar motions to stay a defendant healthcare
provider’s no-fault collection proceeding[s] during the pendency of a plaintiff-insurer’s fraud
and declaratory judgment action.” (Pls.’ Mem. 6 (citations omitted).) Plaintiffs argue that
GEICO satisfies the demands of the preliminary injunction standard. (Id. at 7–20.)
Defendants argue that Plaintiffs fail to establish the elements of a preliminary injunction.
(Defs.’ Opp’n 4–14.)
A party seeking a preliminary injunction “must establish (1) that it is likely to succeed on
the merits, (2) that it is likely to suffer irreparable harm if the injunction is not granted, (3) that
the balance of the equities tips in its favor, and (4) that the injunction serves the public interest.”

SAM Party, 987 F.3d at 273–74; see also Mendez v. Banks, 65 F.4th 56, 63–64 (2d Cir. 2023),
(explaining that the traditional preliminary injunction standard requires plaintiffs to show (1) “a
likelihood of success on the merits or sufficiently serious questions going to the merits . . . ,” (2)
“that [the plaintiffs] are likely to suffer irreparable injury in the absence of an injunction,” (3)
“that the balance of hardships tips in [the plaintiffs’] favor,” and (4) “that the public interest
would not be disserved by the issuance of a preliminary injunction” (internal quotation marks
and citations omitted) (quoting Salinger v. Colting, 607 F.3d 68, 79–80 (2d Cir. 2010))); cert.
denied, 144 S. Ct. 559 (2024); Ventura de Paulino v. N.Y.C. Dep’t of Educ., 959 F.3d 519, 529
(2d Cir. 2020) (noting that “to obtain a preliminary injunction, the movant has to ‘show (a)

irreparable harm and (b) either (1) likelihood of success on the merits or (2) sufficiently serious
questions going to the merits to make them a fair ground for litigation and a balance of hardships
tipping decidedly toward the party requesting the preliminary relief’” (quoting Citigroup Glob.
Mkts., Inc. v. VCG Spec. Opportunities Master Fund Ltd., 598 F.3d 30, 35 (2d Cir. 2010))).
i. Likelihood of success on the merits or sufficiently serious questions
going to the merits
Plaintiffs argue that they have “[s]hown — at a [m]inimum — a [s]erious [q]uestion
[g]oing to the [m]erits” of their claim, and have documented “considerable evidence that
Defendants were not entitled to collect on the bills for the Fraudulent Service.” (Pls.’ Mem. 11.)
In support, Plaintiffs argue that they have provided detailed allegations of Defendants’ “scheme
of fraudulent activity,” and argue three “serious questions” as to Defendants’ behavior as part of
this scheme, including (1) Innovation Anesthesia’s unlawful operations in New Jersey, (id. at
14–15); (2) Defendants’ unlawful compensation in exchange for patient referrals, (id. at 15–16);
and (3) Defendants’ fraudulent treatment and billing protocol, including “misrepresent[ations of]
the nature, extent, and results of their putative examinations” that form “the fraudulent pattern,”

(id. 16–17).
Defendants argue that Plaintiffs fail to present “actual evidence” demonstrating a serious
question or a likelihood of success on the merits. (Defs.’ Opp’n 9.) In support, Defendants
argue that, although “GEICO seeks a stay of all collection proceedings for three separate
practices — Innovation Anesthesia . . . JPM [PT]. . . , and Liberty [Park Chiro]” Plaintiffs “fail[
] to clearly distinguish between these Defendants.” (Id.) Defendants also argue that Plaintiffs
fail to demonstrate that Chen could not provide medical services in New Jersey, (id. at 10), that
“GEICO failed to substantiate the referral and kickback claims with any substantive support
beyond allegations in the Complaint,” (id.), and in particular “GEICO failed to provide an expert

review as to the medical necessity issue in its moving papers,” (id. at 11).
“The ‘serious questions’ standard permits a district court to grant a preliminary
injunction . . . where it cannot determine with certainty that the moving party is more likely than
not to prevail on the merits of the underlying claims, but where the costs outweigh the benefits of
not granting the injunction.” State Farm, 120 F.4th at 82–83 (quoting Citigroup, 598 F.3d at
35); Spanski Enters., Inc. v. Telewizja Polska S.A., 832 F. App’x 723, 724 (2d Cir. 2020)
(quoting same). “The ‘serious questions’ standard allows courts to ‘asses[] the merits of a claim
at the preliminary injunction stage’ by affording considerable ‘flexibility in the face of varying
factual scenarios and the greater uncertainties inherent at the outset of particularly complex
litigation.’” State Farm, 120 F.4th 83 (quoting Citigroup, 598 F.3d at 35); see also Beynin, 2021
WL 1146051, at *6 (“The value of an approach encompassing the serious questions standard
‘lies in its flexibility in the face of varying factual scenarios and the greater uncertainties inherent
at the outset of particularly complex litigation.’”). “District courts in [this] Circuit have
generally found that ‘[l]ikelihood of success is not the focus at the early stages of a case

[involving an alleged scheme to defraud an insurer of assigned no-fault benefits] because any
likelihood of success inquiry would be premature.” Gov’t Emps. Ins. Co. v. Relief Med., P.C.,
554 F. Supp. 3d 482, 498 (E.D.N.Y. 2021) (second and third alterations in original) (quoting
Gov’t Emps. Ins. Co. v. Zaitsev, No. 20-CV-3495, 2021 WL 3173171, at *1 (E.D.N.Y. July 27,
2021)); see Gov’t Emps. Ins. Co. v. Landow, No. 21-CV-1440, 2022 WL 939717, at *12
(E.D.N.Y. Mar. 29, 2022) (same); Gov’t Emps. Ins. Co. v. Advanced Comprehensive Lab’y, LLC,
No. 20-CV-2391, 2020 WL 7042648, at *5 (E.D.N.Y. Dec. 1, 2020) (same); Allstate Ins. Co. v.
Elzanaty, 929 F. Supp. 2d 199, 217 (E.D.N.Y. 2013) (same). “Instead, [district courts] look to
whether there is a serious question going to the merits to make them a fair ground for trial.”

Relief Med., 554 F. Supp. 3d at 498 (alteration in original) (quoting Zaitsev, 2021 WL 3173171,
at *1); see Gov. Emps. Ins. Co. v. Demesmin, No. 23-CV-6191, 2024 WL 4573698, at *2
(E.D.N.Y. Oct. 23, 2024) (quoting Wellmart, 435 F. Supp. 3d at 449) (same); see also Gov.
Emps. Ins. Co. v. Zilberman, No. 20-CV-209, 2021 WL 1146086, at *1–2 (E.D.N.Y. Mar. 25,
2021) (applying the “serious question” standard in no-fault proceeding); Advanced
Comprehensive Lab’y, 2020 WL 7042648, at *5–6 (same); Wellmart, 435 F. Supp. 3d at 453–55
(same); State Farm Mut. Auto. Ins. Co. v. Parisien, 352 F. Supp. 3d 215, 220, 234 (E.D.N.Y.
2018) (same).
A medical professional corporation is prohibited from “directly or indirectly offering [or]
giving . . . any fee or other consideration to or from a third party for the referral of a patient . . .
in connection with the performance of professional services.” N.Y. Comp. Codes R. & Regs. tit.
8, § 29.1(b)(3); see also Gov’t Emps. Ins. Co. v. Jacques, No. 14-CV-5299, 2017 WL 9487191,
at *2 (E.D.N.Y. Feb. 13, 2017) (“New York also prohibits paying kick-backs for patient

referrals.” (citing N.Y. Comp. Codes R. & Regs. tit. 8, § 29.1(b)(3))), report and
recommendation adopted, 2017 WL 1214460 (E.D.N.Y. Mar. 31, 2017); Arthur Ave. Med.
Servs., PC v. GEICO Ins. Co., 148 N.Y.S.3d 356, 361 (Civ. Ct. 2021) (“[A medical] corporation
may not share professional service fees with third parties, such as referral fees.” (citing N.Y.
Comp. Codes R. & Regs. tit. 8, § 29.1(B)(4))). “If a medical professional corporation engages in
. . . unprofessional conduct, it is rendered ineligible for a requested no-fault reimbursement by
virtue of [N.Y. Comp. Codes R. & Regs., tit. 11] § 65-3.16(a)(12).” Mayzenberg, 2018 WL
6031156, at *7 (quoting Gov’t Emps. Ins. Co. v. Badia, No. 13-CV-1720, 2015 WL 1258218, at
*9 (E.D.N.Y. Mar. 18, 2015)); see also Jacques, 2017 WL 9487191, at *2 (“To be eligible for

reimbursement payments under the no-fault law, a provider of healthcare services must comply
with applicable licensing requirements.” (citing N.Y. Comp. Codes R. & Regs. tit. 11, § 65-
3.16(a)(12))). “New York law [also] provides that defendants may be held liable for medically
unnecessary services under New York’s [no-fault] insurance laws.” Advanced Comprehensive
Lab’y, 2020 WL 7042648, at *7 (citing Long Is. Radiology v. Allstate Ins. Co., 830 N.Y.S.2d
192, 194 (App. Div. 2007)). “[A] complaint alone can be sufficient to grant an injunction, [and]
[t]his is particularly true where . . . the complaint comprehensively details regulatory violations,
unnecessary medical services, and unlawful referrals.” Gov. Emps. Ins. Co. v. Moshe, No. 20-
CV-1098, 2020 WL 3503176, at *2 (E.D.N.Y. June 29, 2020) (collecting cases).
Plaintiffs allege that Defendants (1) used a predetermined treatment protocol, with
Innovation Anesthesia and Chen acting as gatekeepers, and subjecting patients to “initial
examinations” the results of which were “routinely falsified,” (Pls.’ Mem. 4, 17); (2) based on
the findings of these examinations, Defendants diagnosed “substantially identical” deficiencies
and injuries to patients, (id. at 17 (emphasis omitted)); (3) referred patients to providers who paid

kickbacks for the referrals under the guise of “lease” agreements, and “return referrals back” to
the Referring Defendants “for continued provision of medically unnecessary chiropractic,
acupuncture, and physical therapy treatment,” (id. at 15); and (4) submitted “thousands of bills”
to Plaintiffs through Innovation Anesthesia, JPM PT, Liberty Park Chiro, and Hao Acupuncture
for the services detailed above while concealing the existence of the “secret agreements” to refer
patients for “expensive and medically unnecessary interventional pain management services” in
exchange for return referrals and illegitimate payments disguised as legitimate “lease” payments,
(id. at 15, 17). These allegations sufficiently demonstrate a serious question going to the merits.
See Demesmin, 2024 WL 4573698, at *4 (finding that the plaintiffs had “establish[ed] a serious

question going to the merits” where the amended complaint detailed “a complex scheme of
fraudulent billing and referrals among a network of chiropractic providers” and “numerous
examples of charges billed without proper documentation or under suspicious circumstances”);
Zaitsev, 2021 WL 3173171, at *2 (finding a serious question going to the merits where the
complaint “detailed allegations of a complex scheme of fraudulent activity,” including, inter
alia, that the defendants “submitted charges . . . for healthcare services that were medically
unnecessary,” “provided the alleged fraudulent healthcare services pursuant to illegal kickback
and self-referral arrangements,” and “misrepresented that they were in compliance with all
relevant laws and regulations”); Beynin, 2021 WL 1146051, at *6 (finding a serious question
going to the merits where the plaintiffs’ complaint “detail[ed] a complicated scheme of alleged
fraudulent activity” that “[gave] rise to an ‘inference . . . that the treatments [we]re . . . not being
provided on the basis of medical necessity’” (third and fourth alterations in original) (first
quoting Elzanaty, 929 F. Supp. 2d at 222; and then quoting Parisien, 352 F. Supp. 3d at 229));
Zilberman, 2021 WL 1146086, at *2 (finding a serious question going to the merits where the

“complaint provide[d] an extremely detailed overview of a complicated scheme” in which, inter
alia, the defendants were alleged to have “provided fraudulent healthcare services that were not
medically necessary” and “relied upon illegal kickback arrangements”); Advanced
Comprehensive Lab’y, 2020 WL 7042648, at *6 (finding a serious question going to the merits
where “the billed-for services were ‘medically unnecessary and were provided — to the extent
that they were provided at all — pursuant to pre-determined fraudulent protocols designed to
financially enrich the [d]efendants’” (citation omitted)); Moshe, 2020 WL 3503176, at *2 (noting
that a “plethora of precedent demonstrates courts routinely find a ‘serious question going to the
merits’ under similar circumstances” (first citing Gov’t Emps. Ins. Co. v. Strut, No. 19-CV-728,

2020 WL 1820500 (W.D.N.Y. Apr. 10, 2020); then citing Parisien, 352 F. Supp. 3d at 234; and
then citing Elzanaty, 929 F. Supp. 2d at 222)); Gov’t Emps. Ins. Co. v. Cean, No. 19-CV-2363,
2019 WL 6253804, at *5 (E.D.N.Y. Nov. 22, 2019) (finding a serious question as to the merits
where the plaintiffs alleged “facts relating to [the defendants’] fraudulent activity in [their]
[c]omplaint, describing fraudulent medical treatment, deceitful billing protocols, and an illegal
kickback and referral scheme”).
Contrary to Defendants’ claims that Plaintiffs fail to allege sufficiently specific instances
of treatments and payments to meet their evidentiary burden, (Defs.’ Opp’n 2, 9), Plaintiffs
allege in the 121-page Complaint detailed allegations of Defendants’ fraudulent treatment and
kickback scheme, including specific details related to: (1) the operational history of 93-16
Liberty Avenue, in addition to the shifting nature of the “lease” kickback fees paid for patient
referrals that “were not for fixed fees set in advance, and did not cover any regular lease terms,”
(Compl. ¶¶ 61–66); (2) the relationship among Defendants with respect to business dealings,
ownership of corporate entities, employment, and financial arrangements, (id. ¶¶ 3–4, 8–15); (3)

the operations of the overall scheme granting access to patients in exchange for referrals and
payments for medically unnecessary services, (id. ¶¶ 47–250); and (4) the medically unnecessary
services allegedly provided, including specific allegations about the nature of each type of
treatment or test provided, (id.).
Because Plaintiffs allege in the Complaint extensive detail as to the alleged fraudulent
practices, the Court finds that Plaintiffs have satisfied their evidentiary burden. See State Farm,
120 F.4th at 84 (concluding that plaintiff insurance companies “demonstrated sufficiently serious
questions going to the merits” where plaintiffs “describe[d] a web of interconnected relationships
among the various [d]efendants, illegal financial arrangements tying many of the [d]efendants

together, medically unnecessary treatment and services provided to patients, and unauthorized
ownership or operation of medical facilities by some [d]efendants”); Gerling, 718 F. Supp. 3d at
276–77 (finding plaintiffs described the scheme in sufficient detail by alleging that “medically
unnecessary procedures were performed pursuant to an illegal patient-brokering scheme . . .
where bills for reimbursement were submitted with misrepresentations in order to maximize . . .
financial gain” and the complaint “recite[d] dozens of specific examples”); Zaitsev, 2021 WL
3173171, at *2 (holding that the allegations supporting the preliminary injunction “are not
conclusory since they are supported by detailed examples throughout the complaint,” including
“specific patients and treatment dates”); Advanced Comprehensive Lab’y, 2020 WL 7042648, at
*4–5 (rejecting the defendants’ argument that “the evidence proffered by [the plaintiff] [wa]s
insufficient to satisfy the elements for injunctive relief” because the plaintiffs alleged that the
defendants “perpetrated a fraudulent medical billing scheme where [the] defendants submitted
medically unnecessary claims for reimbursement to [the plaintiffs] in furtherance of [the]
defendants’ financial gain” and “provide[d] specific factual examples of [the] defendants’

allegedly fraudulent scheme and exploitation of the New York [no-fault] insurance system”);
Moshe, 2020 WL 3503176, at *2 (“While many courts have granted injunctions after considering
a more developed record, a complaint alone can be sufficient to grant an injunction. This is
particularly true where, as here, the complaint comprehensively details regulatory violations,
unnecessary medical services, and unlawful referrals.” (first citing Strut, 2020 WL 1820500, at
*2; and then citing Liberty Mut. Ins. Co. v. Excel Imaging, 879 F. Supp. 2d 243, 254–64
(E.D.N.Y. 2012))); Strut, 2020 WL 1820500, at *2 (rejecting implausibility argument where the
complaint provided “numerous examples to support each of [the plaintiff’s] fraud theories, citing
specific patients, accident dates, and treatment dates”); Cean, 2019 WL 6253804, at *5 (finding a

serious question going to the merits where plaintiffs “alleged, in significant detail, facts relating
to [the] [d]efendants’ fraudulent activity in [their] [c]omplaint, describing fraudulent medical
treatment, deceitful billing protocols, and an illegal kickback and referral scheme”); Parisien,
352 F. Supp. 3d at 234 (holding that, in light of the plaintiffs’ allegations and exhibits, “it cannot
be said that [the plaintiffs’] request for injunctive relief ‘rest[ed] on mere hypotheticals’”
(quoting Hancock v. Essential Res., Inc., 792 F. Supp. 924, 928 (S.D.N.Y. 1992))).
Although the question of whether under New York law improper payments for patient
referrals alone is sufficient to justify an insurer denying payment for no-fault benefits is pending,
see Gov. Emps. Ins. Co. v. Mayzenberg, 121 F.4th 404, 421 (2d Cir. 2024), certified question
accepted, 42 N.Y.3d 1045 (2024); 42 N.Y.3d at 1045, in addition to alleging a scheme of hidden
“lease” payments among Defendants for referrals, Plaintiffs also allege that the scheme depends
on systemic illegitimate “return referrals,” (Compl. ¶ 67), Innovation Anesthesia’s unlawful
provision of professional services in New Jersey, (id. ¶¶ 47–53), and submitting fraudulent
billing, (id. ¶¶ 34–53, 252).

Accordingly, Plaintiffs have shown a serious question as to whether Defendants are
eligible to receive reimbursement for no-fault benefits.
ii. Irreparable harm
Plaintiffs argue that “GEICO will suffer irreparable harm absent a stay and injunction . . .
. ” (Pls.’ Mem. 7.) In support, Plaintiffs argue that they are “faced with 760 individual no-fault
arbitration proceedings and more than 200 individual lawsuits” such that “potentially dozens of
inconsistent awards . . . will frustrate GEICO’s attempt to obtain declaratory relief in this
action.” (Id.) Plaintiffs also argue that “in analogous no-fault insurance fraud cases, the risk of
inconsistencies between arbitrations and collection lawsuits and a court’s ruling establishes

irreparable harm.” (Id.)
Defendants argue that Plaintiffs have failed to prove irreparable harm because “‘mere
injuries . . . in terms of money, time and energy necessarily expended’ absent a stay of ongoing
state court and arbitration proceedings ‘are not enough’ to establish irreparable harm” where
Plaintiffs could be “fully compensated through money damages.” (Defs.’ Opp’n 4–6 (quoting
Allstate Ins. Co. v. Harvey Fam. Chiropractic, 677 F. App’x 716, 718 (2d Cir. 2017)).)
Irreparable harm is “the single most important prerequisite for the issuance of a
preliminary injunction.” State Farm, 120 F.4th at 80 (quoting Faiveley Transp. Malmo AB v.
Wabtec Corp., 559 F.3d 110, 118 (2d Cir. 2009)); Gov’t Emps. Ins. Co. v. Barakat, 709 F. Supp.
3d 93, 100 (E.D.N.Y. 2024) (“The showing of irreparable harm is perhaps the single most
important prerequisite for the issuance of a preliminary injunction . . . .” (quoting Elzanaty, 929
F. Supp. 2d at 221)). To establish irreparable harm, “the moving party ‘must demonstrate that
absent a preliminary injunction [it] will suffer an injury that is neither remote nor speculative, but
actual and imminent, and one that cannot be remedied if a court waits until the end of trial to

resolve the harm.’” State Farm, 120 F.4th at 80 (alteration in original) (quoting Faiveley
Transp., 559 F.3d at 118). “Thus, irreparable harm exists ‘where, but for the grant of equitable
relief, there is a substantial chance that upon final resolution of the action the parties cannot be
returned to the positions they previously occupied.’” Id. at 80 (quoting Brenntag Int’l Chems.,
Inc. v. Bank of India, 175 F.3d 245, 249 (2d Cir. 1999)). Absent “extraordinary circumstances,”
injunctions are also unavailable “[w]here there is an adequate remedy at law, such as an award of
money damages.” Id. (quoting Moore, 409 F.3d at 510). “[T]he moving party must show that
‘there is a continuing harm which cannot be adequately redressed by final relief on the merits
and for which money damages cannot provide adequate compensation.’” Id. (quoting Kamerling

v. Massanari, 295 F.3d 206, 214 (2d Cir. 2002)). “Courts have readily held that irreparable harm
occurs where . . . an insurer is required to waste time defending numerous no-fault actions when
those same proceedings could be resolved globally in a single, pending declaratory judgment
action.” Parisien, 352 F. Supp. 3d at 233 (first citing Gov’t Emps. Ins. Co. v. Strutsovskiy, No.
12-CV-330, 2017 WL 4837584, at *6 (W.D.N.Y. Oct. 26, 2017); and then citing Elzanaty, 929
F. Supp. 2d at 222); see, e.g., Gerling, 718 F. Supp. 3d at 274 (finding the plaintiffs
demonstrated irreparable harm because “if [the defendants were] permitted to continue pursuing
collection arbitrations during the pendency of th[e] lawsuit,” the “arbitration actions ‘might
eventually be, at best, inconsistent with th[e] [c]ourt’s ruling, and at worst, essentially
ineffective’” (quoting Elzanaty, 929 F. Supp. 2d at 222)); see also Zaitsev, 2021 WL 3173171, at
*2 (“Courts in this Circuit have found . . . that ‘[i]rreparable harm occur[ed] where “an insurer is
required to waste time defending numerous no-fault actions when those same proceedings could
be resolved globally in a single, pending declaratory judgment action.”’” (second and third
alterations in original) (quoting Moshe, 2020 WL 3503176, at *1) (collecting cases)).

Plaintiffs have sufficiently demonstrated that they will suffer irreparable harm absent a
stay and injunction. Plaintiffs’ assertions that, absent the requested injunctive relief, the “760
individual no-fault arbitration proceedings and more than 200 individual lawsuits pending” will
risk “inconsistent awards before multiple arbitrators” and “frustrate [Plaintiffs’] attempt to obtain
declaratory relief in this action,” are sufficient to demonstrate irreparable harm. (Pls.’ Mem. 7.)
See Gerling, 718 F. Supp. 3d at 276, 276 n.3, 279 (finding that the fact there were just four
pending arbitrations was not “dispositive,” but nonetheless was sufficient to demonstrate
irreparable harm absent a stay due to the risk of inconsistent judgments, the potential
unavailability of money damages, and the risk that “fragmenting” the dispute into the

approximately fifty or more pending lawsuits “would nullify [plaintiffs’] efforts to prove fraud at
a systemic level” and “deprive [plaintiffs] of an avenue toward complete relief in any court”);
Zaitsev, 2021 WL 3173171, at *2 n.3 (noting that although Harvey concluded that “wasted time
and resources do not constitute irreparable harm,” “Harvey does not preclude granting an
injunction to avoid inconsistent judgments” (quoting Moshe, 2020 WL 3503176, at *2)); Beynin,
2021 WL 1146051, at *4–6 (concluding that “the likely inconsistencies amongst the prospective
arbitral rulings themselves, and between the prospective arbitral rulings and th[e] [c]ourt’s
ultimate disposition of the declaratory judgment and fraud-based claims” constituted irreparable
harm (citation omitted) (collecting cases)); Advanced Comprehensive Lab’y, 2020 WL 7042648,
at *5 (rejecting the defendants’ argument based on Harvey that the plaintiff will not suffer
irreparable harm and noting that if the defendants were “permitted to prosecute the ongoing
collection proceedings, [the plaintiff] faces imminent and non-speculative risks of inconsistent
judgments and unnecessary expenditure of time and resources on arbitration,” which shows
irreparable harm); Cean, 2019 WL 6253804, at *5 (concluding “that wasting time and resources

in arbitrations with awards that might eventually be, at best, inconsistent with judicial rulings
and, at worst, essentially ineffective, constitutes irreparable harm”); Mayzenberg, 2018 WL
6031156, at *5 (noting that unlike the injuries noted in Harvey, “it is the inconsistency to which
hundreds of arbitrations will inevitably give rise, the frustration of the declaratory judgment
relief for which [the plaintiff] is likely to succeed on the merits, and the resources spent vacating
hundreds of arbitration awards that satisfies the irreparable harm prong”); Strutsovskiy, 2017 WL
4837584, at *7 (staying no-fault collection arbitrations pending the resolution of the plaintiff’s
declaratory judgment action and rejecting the notion that Harvey barred a preliminary
injunction); Elzanaty, 929 F. Supp. 2d at 222 (finding that “allowing a large number of

proceedings to be heard by a mix of arbitrators, each of whom will likely come to their own
independent and potentially contradictory conclusions, will result in harm to [the plaintiff] from
which it cannot recover”). In addition, in the month following Plaintiffs’ filing of their
complaint Innovation Anesthesia, JPM PT, and Liberty Park Chiro initiated over 500 suits and
arbitrations seeking to collect on the same bills at issue in the Complaint, (Pls.’ Mem. 5), all of
which supports Plaintiffs’ demonstration of irreparable harm from the real risk of future
proceedings. See Gerling, 718 F. Supp. 3d at 277 (explaining that plaintiffs would be irreparably
harmed if “future collection proceedings are not enjoined”); Advanced Comprehensive Lab’y,
2020 WL 7042648, at *4 (“Moreover, under these circumstances, the court agrees that [the
plaintiff] will suffer irreparable injury that ‘is neither remote nor speculative’ without injunctive
relief because [the defendant] continues to commence arbitrations before the AAA.” (quoting
Grand River Enter. Six Nations, Ltd. v. Pryor, 481 F.3d 60, 66 (2d Cir. 2007))).
The Court is not persuaded by Defendants’ arguments as to why Plaintiffs have allegedly
not shown irreparable harm. First, Defendants argue that the “risk of inconsistent outcomes

between [the federal action] and the no-fault arbitrations that will frustrate [Plaintiffs’] attempt
for declaratory relief” is insufficient to demonstrate irreparable harm, (Defs.’ Mem. 5), but
Defendants’ reliance on Harvey is misplaced. The Second Circuit has distinguished Harvey —
where the defendant was an “illegally owned and improperly licensed” business, Allstate Ins. Co.
v. Harvey Fam. Chiropractic, Physical Therapy & Acupuncture, PLLC, No. 15-CV-7149, 2018
WL 8544440, at *1 (E.D.N.Y. Sept. 21, 2018), and was not operating a complicated scheme that
would be difficult to establish in arbitrations and state-court proceedings — from cases where
defendants engage in a “massive and highly complex scheme” which can be “obscured in . . .
piecemeal proceedings” and where the “potential preclusive effects of the arbitrations and state-
court proceedings” are a significant harm. 8 State Farm, 120 F.4th at 81–82. As other courts in

this Circuit have noted, Harvey “does not address the risk of inconsistent judgments.” Strut,
2020 WL 1820500, at *3 (citing Harvey, 677 F. App’x at 718); see also Moshe, 2020 WL
3503176, at *2 (“Harvey does not preclude granting an injunction to avoid inconsistent

8 In Allstate Ins. Co. v. Harvey Family Chiropractic, the Second Circuit summarily
affirmed the district court’s denial of a preliminary injunction of no-fault proceedings and noted
(1) that there was “no evidence in the record that” the plaintiffs could not “be fully compensated
through money damages for the alleged harm suffered from the defendants’ fraudulent claims”
and (2) that “[e]ven if the defendants obtain[ed] other [no-fault] reimbursements in state court
and arbitrations while th[e] case [was] pending, the plaintiffs [were] free to recover those
payments [if] they prevail[ed] on their RICO claim.” 677 F. App’x 716, 718 (2d Cir. 2017).
judgments.” (citing Wellmart, 435 F. Supp. 3d at 451)); Wellmart, 435 F. Supp. 3d at 451
(“[T]he Second Circuit [in Harvey] said nothing of the risk of inconsistent judgments.”).
Second, Defendants argue that Plaintiffs can resolve their disputes in the “no-fault
arbitration system,” because “[t]he no-fault statute was passed by the legislature so that medical
providers would have an expedited forum to obtain reimbursement from insurers for automobile

injury claims without having to spend time and resources in protracted litigation.” (Defs.’ Opp’n
7–8.) However, the arbitration system does not provide sufficient guarantees of procedural
safeguards to address concerns regarding the complexity of the scheme at issue before the Court.
See Mun, 751 F.3d at 99 (“New York’s arbitration process for no-fault coverage is an expedited,
simplified affair meant to work as quickly and efficiently as possible. Discovery is limited or
non-existent. Complex fraud and RICO claims . . . cannot be shoehorned into this system.”
(citation omitted)); Advanced Comprehensive Lab’y, 2020 WL 7042648, at *2 (same);
Mayzenberg, 2018 WL 6031156, at *6 (same); see Beynin, 2021 WL 1146051, at *6 (“In brief,
the [arbitration] process is ‘meant to work as quickly and efficiently as possible,’” such that “the

claims brought in this action cannot be meaningfully pursued in no-fault insurance proceedings.”
(quoting Mun, 751 F.3d at 99)); Parisien, 352 F. Supp. 3d at 229 (“Because it is only through
this tapestry of facts that the alleged fraud comes into focus, [the plaintiffs] may not as a
practical matter have a fair opportunity to present [their] claims unless [they are] permitted to
direct the trier of fact to all of the claims at issue.”); cf. State Farm, 120 F.4th at 92 (explaining
that the Federal Arbitration Act did not bar the Court from enjoining arbitrations proceeding
under New York’s process for no-fault coverage because “the thousands of allegedly baseless
arbitrations . . . [would] help to further the massive and complex RICO scheme alleged”).
Accordingly, the Court finds that Plaintiffs have shown irreparable harm.
iii. Balance of hardships
Plaintiffs argue that “[t]he [b]alance of [h]ardship [w]eighs in [f]avor of a [s]tay.” (Pls.’
Mem. 17.) In support, Plaintiffs argue that, absent a stay, they “will face a multitude of
individual arbitrations,” and risk “fragmented results” in no small part because “[Plaintiffs’]
evidence of fraud consists of information from multiple claims . . . [and their] ability to take

discovery and present evidence of this level of complexity is practically impossible in the context
of a single state court collection lawsuit. (Id. at 18, 22 (internal quotation marks and citations
omitted).) Plaintiffs also argue that “Defendants will suffer no hardship if their right to collect
on their pending billing is adjudicated in a single, efficient, declaratory judgment action, rather
than on a piecemeal basis in multiple collection proceedings with the prospect of significantly
varying outcomes.” (Id. at 17–18 (citations omitted).)
Defendants argue that “[t]he [b]alance of [h]ardships [t]ips [d]ecidedly” in their favor,
because “a preliminary injunction would force Defendants to work for free, while [Plaintiffs]
den[y] claims and avoid[ ] the statutory arbitration process . . . . [which] causes an extreme

imbalance [because] Defendants [do] not have the same money and resources as [Plaintiffs].”
(Defs.’ Opp’n 12.)
Under the third prong of the preliminary injunction analysis, a court must “balance the
competing claims of injury and must consider the effect on each party of the granting or
withholding of the requested relief.” State Farm, 120 F. 4th at 84 (quoting Yang v. Kosinski, 960
F.3d 119, 135 (2d Cir. 2020)). If there are “sufficiently serious questions going to the merits of
its claims to make them fair ground for litigation,” courts inquire into whether there is “a balance
of the hardships tipping decidedly in favor of the moving party.” Really Good Stuff, LLC v. BAP
Invs., L.C., 813 F. App’x 39, 42–43 (2d Cir. 2020) (quoting Oneida Nation of N.Y. v. Cuomo,
645 F.3d 154, 164 (2d Cir. 2011)); State Farm, 120 F.4th at 79–80 (“Because under the ‘serious
questions’ standard a party would have to demonstrate both serious questions on the merits and a
balance of hardships decidedly favoring the moving party, the ‘overall burden is no lighter than
the one [the party] bears under the “likelihood of success” standard.’” (quoting Citigroup, 598
F.3d at 35)); see also TushBaby, Inc. v. Jinjang Kangbersi Trade Co. Ltd., No. 24-CV-6150,

2024 WL 4627452, at *2 (S.D.N.Y. Oct. 30, 2024) (same); Parisien, 352 F. Supp. 3d at 234
(“Because the [c]ourt finds that there are ‘serious questions going to the merits’ in lieu of a
‘likelihood of success on the merits,’ it must further inquire as to whether . . . there is a ‘balance
of hardships tipping decidedly’ in [the plaintiff’s] favor.” (quoting Jackson Dairy, Inc. v. H. P.
Hood & Sons, Inc., 596 F.2d 70, 72 (2d Cir. 1979))).
Absent a preliminary injunction, Plaintiffs face 750 pending arbitrations and 200
individual pending lawsuits, and likely hundreds or thousands of additional arbitrations and
state-court proceedings to resolve the over $3 million of Defendants’ total submitted bills
currently unpaid and not yet subject to arbitration or court proceedings. (Pls.’ Mem. 7, 5.)

Defendants do not appear to face a similar level of uncertainty in their competing concern of
policy exhaustion, as they speak generally of exhaustion risk without identifying any specific set
of policies nearing exhaustion. (Defs.’ Opp’n 13 (“Each of the underlying insureds who received
treatment from Defendants have policies that contain a no-fault insurance limit . . . Given that
many policy limits are quite low in comparison to the treatment required, the policies can be
exhausted very quickly.”).) See State Farm, 120 F.4th at 85 (affirming the Court’s conclusion
that plaintiff insurance companies’ allegations of a fraudulent conspiracy “raise[d] serious and
substantial allegations that demonstrate actual and imminent irreparable harm absent and
injunction, whereas [d]efendants’ alleged hardships of economic impact can be remedied by
monetary damages should they later prevail”); Moshe, 2020 WL 3503176, at *3 (finding that the
balance of hardships weighed in favor of the insurer where the insurer “will face thousands of
different proceedings” and defendants’ policy exhaustion argument “[was] speculative at best
considering defendants [did] not identify any policies nearing exhaustion”).
Moreover, Defendants are entitled to interest if they prevail. See Demesmin, 2024 WL

4573698, at *4 (noting that “[b]ecause the defendants will presumably be entitled to collect
interest on their pending claims if they prevail, the delay [did] not outweigh the risk of
inconsistent outcomes faced by [the plaintiff]” (citation omitted)); Elzanaty, 929 F. Supp. 2d at
222 (noting that the defendants will “benefit from the stay if [they] ultimately prevail[] in th[e]
matter, because [they] will be entitled to the collection of interest”); Zaitsev, 2021 WL 3173171,
at *3 (noting that the “defendants will not be disadvantaged if the stay is granted since they will
be entitled to statutory interest on their unpaid claims should they ultimately prevail” (first citing
Elzanaty, 929 F. Supp. 2d at 222; and then citing Mayzenberg, 2018 WL 6031156, at *7));
Mayzenberg, 2018 WL 6031156, at *7 (“[I]f [the defendants] prevail in this action, they are

entitled to statutory interest on their unpaid claims.”); Parisien, 352 F. Supp. 3d at 234–35 (“If
the preliminary injunction is granted and [the plaintiffs] fail[] to prove [their] claims, then, at
worst, [the defendants’] recovery of the no-fault benefits to which they are entitled will be
delayed; all [the defendants] can hope for in pursuing their parallel state lawsuits and arbitrations
is to accelerate their receipt of benefits to which they are already entitled.”).
A stay of pending and future arbitrations and lawsuits addressing similar claims will save
the parties time and resources and promote judicial efficiency. See Gerling, 718 F. Supp. 3d at
278 (concluding that “granting the stay and injunction will actually save all parties time and
resources[,] because all claims can be efficiently and effectively dealt with in a single declaratory
judgment action rather than in piecemeal fashion” (internal quotation marks and citation
omitted)); Beynin, 2021 WL 1146051, at *8 (holding that “consolidation promotes efficiency in
cases like this . . . notwithstanding [the defendants’] claim that they will suffer financially,”
especially where “they have not specified the extent of that hardship — e.g., how much of their
income the outstanding and pending claims constitute” (first citing Cean, 2019 WL 6253804, at

*5; and then citing Advanced Comprehensive Lab’y, 2020 WL 7042648, at *8)); Zilberman,
2021 WL 1146086, at *2 (“[G]ranting the stay and injunction will actually save all parties time
and resources. Rather than adjudicating hundreds of individual claims in a piecemeal fashion, all
claims can be efficiently and effectively dealt with in a single declaratory judgment action.”
(first quoting Cean, 2019 WL 6253804, at *5; and then citing Elzanaty, 929 F. Supp. 2d at 222));
Strut, 2019 WL 6338023, at *8 (stating that “[j]udicial economy tips the balance of those
equities decidedly in [the plaintiffs’] favor” where the plaintiffs would otherwise “have to make
payments on claims with serious questions about consistency” (citing Strutsovskiy, 2017 WL
4837584, at *7)); Mayzenberg, 2018 WL 6031156, at *7 (“[I]t is obviously more efficient and

beneficial for [the defendants] if all of their claims are resolved in one action, rather than in
hundreds of different proceedings.”).
Accordingly, the Court finds that the balance of hardships tips decidedly in Plaintiffs’
favor.
iv. Public interest
Plaintiffs argue that “[f]ar from creating friction between the state and federal courts, an
injunction in this case will serve the public policy of New York in combatting insurance fraud in
the no-fault sector.” (Pls.’ Mem. 23 (quoting Gov’t Emps. Ins. Co. v. Wallegood, Inc., No. 21-
CV-1986, slip op. at 18 (E.D.N.Y. July 16, 2021) (order granting preliminary injunction)))
(internal quotation marks omitted).) Plaintiffs also argue that in a dispute between private
parties, “it is not required to demonstrate that the proposed injunction will not harm the public
interest . . . [but] it is well within the public interest to stay No-Fault collection proceedings
during the pendency of a plaintiff-insurers declaratory judgment action involving claims of
fraud.” (Id. at 19 n.20 (citing In re Soundview Elite Ltd., 543 B.R. 78, 118 n.210 (Bankr.

S.D.N.Y. 2016) (“Normally the public interest is not a factor on preliminary injunction
applications involving private disputes.”).) Defendants make no argument as to the public
interest factor.
In analyzing the public interest prong, a court must consider “the public consequences in
employing the extraordinary remedy of injunction,” Yang, 960 F.3d at 135–36 (quoting Winter,
555 U.S. at 24), and ensure that the proposed injunction “does not cause harm to the public
interest,” SEC v. Citigroup Glob. Mkts. Inc., 673 F.3d 158, 163 n.1 (2d Cir. 2012) (per curiam);
see also State Farm, 120 F.4th at 85 (explaining that courts “consider whether the preliminary
injunction is in the public interest, which concerns the ‘public consequences in employing the

extraordinary remedy of injunction’” (quoting Yang, 960 F.3d at 135–36)).
There is no indication that granting an injunction would harm the public interest. See
State Farm, 120 F.4th at 85 (“Preventing fraud, especially the kind of elaborate and complex
RICO scheme alleged here, is plainly in the public interest.” (quoting Mun, 751 F.3d at 100));
Beynin, 2021 WL 1146051, at *10 (noting that “preventing fraud of the sort alleged [under New
York’s no-fault laws] is in the public interest” (citing Wellmart, 435 F. Supp. 3d at 456)); Strut,
2020 WL 1820500, at *3 n.8 (finding that the public interest factor in a preliminary injunction
and stay as to no-fault proceedings was neutral); Mayzenberg, 2018 WL 6031156, at *10 (noting
that “[p]reventing fraud on our health care system is also in the public’s interest” where
“allegations of fraud on our health care system generally, and even the specific civil RICO
scheme alleged here, have become too common”).
Because there are serious questions going to the merits of the case, Plaintiffs would suffer
irreparable harm absent a stay, the balance of hardships weighs in Plaintiffs’ favor, and there is
no indication that the public interest would be harmed as a result of a stay, the Court grants

Plaintiffs’ motion to stay all pending arbitrations and state court proceedings and to enjoin all
future arbitrations and state court proceedings.
d. Security for the injunction
Plaintiffs argue that no bond should be required because they have provided “detailed and
plausible fraud claims,” they have “already paid the Defendants over $6,300,000 on their
allegedly-fraudulent claims,” they contend there is no “plausible claim that GEICO ultimately
might be unable to compensate any wrongfully-enjoined Defendants,” and that “Defendants’
arguments regarding insurance policy exhaustion are . . . speculative and without factual
support.” (Pls.’ Reply 10.) Plaintiffs also argue that most courts do not require it to post bond.
(Id. (citations omitted).)

Defendants argue that Plaintiffs should be required to post bond because “if any
injunction is issued, a bond is needed to cover Defendants’ outstanding claims plus interest, an
amount which continues to grow.” (Defs.’ Opp’n 14–15 (citing Strut, 2020 WL 1820500, at
*3).)
Rule 65(c) of the Federal Rules of Civil Procedure states that “the court may issue a
preliminary injunction . . . only if the movant gives security in an amount that the court considers
proper to pay the costs and damages sustained by any party found to have been wrongfully
enjoined or restrained.” Fed. R. Civ. P. 65(c); see also State Farm, 120 F.4th at 86 (quoting
same). “The phrase in such sum as the court deems proper[] indicates that the [d]istrict [c]ourt is
vested with wide discretion in the matter of security[,] and it has been held proper for the court to
require no bond where there has been no proof of likelihood of harm . . . .” Dr.’s Assocs., Inc. v.
Stuart, 85 F.3d 975, 985 (2d Cir. 1996) (internal quotation marks omitted) (first quoting
Ferguson v. Tabah, 288 F.2d 665, 675 (2d Cir. 1961); and then citing Clarkson Co. v. Shaheen,
544 F.2d 624, 632 (2d Cir. 1976)); see also State Farm, 120 F.4th at 86 (“Courts have the

discretion, however, to require no security at all depending on the specific circumstances.”
(quoting Corning Inc. v. PicVue Elecs., Ltd., 365 F.3d 156, 158 (2d Cir. 2004))); Gerling, 718 F.
Supp. 3d at 280 (“Courts in this district have repeatedly reasoned that the enforcement of no-
fault insurance statutes is in the public interest, as is the prevention of fraud on the healthcare
system, and, accordingly, have waived the security requirement upon identifying the ‘systemic
nature of the fraud alleged in the complaint and the lack of prejudice to defendants resulting from
a preliminary injunction.’” (quoting Wellmart, 435 F. Supp. 3d at 456)); Dr.’s Assocs. LLC v.
Hai, No. 19-CV-1968, 2019 WL 2385597, at *5 (E.D.N.Y. June 6, 2019) (“[A] district court in
its discretion may deny a bond altogether if there is ‘no proof of likelihood of harm’ to the non-

movant.” (alteration in original) (quoting Golden Krust Patties, Inc. v. Bullock, 957 F. Supp. 2d
186, 202 (E.D.N.Y. 2013))). “Rule 65(c)’s security requirement is designed to ‘assure[] the
enjoined party that it may readily collect damages from the funds posted in the event that it was
wrongfully enjoined, and that it may do so without further litigation and without regard to the
possible insolvency of the plaintiff.’” State Farm, 120 F.4th at 86 (alteration in original)
(quoting Nokia Corp. v. InterDigital, Inc., 645 F.3d 553, 557 (2d Cir. 2011)); U.S. D.I.D. Corp.
v. Windstream Commcns, Inc., 775 F.3d 128, 135 (2d Cir. 2014) (quoting same).
Because Plaintiffs have established a likelihood of harm, a stay is unlikely to prejudice
Defendants, and Defendants may readily collect damages from Plaintiffs, the Court declines to
require Plaintiffs to post a bond. See Demesmin, 2024 WL 4573698, at *5 (waiving security
under Rule 65(c) because “there is no question that [plaintiffs] will be able to pay if the
defendants prevail”); Zaitsev, 2021 WL 3173171, at *3 (waiving Rule 65(c) requirement where
“the requested injunction will not cause [the defendants] any prejudice at all” and “[the insurer]
undoubtedly has the ability to pay if defendants prevail” (first quoting Moshe, 2020 WL

3503176, at *4; then citing Wellmart, 435 F. Supp. 3d at 456; and then citing Mayzenberg, 2018
WL 6031156, at *10)); Beynin, 2021 WL 1146051, at *10 (waiving the security requirement of
Rule 65(c) where the parties “may well benefit from consolidation and interest” (first citing
Cean, 2019 WL 6253804, at *5; and then citing Elzanaty, 929 F. Supp. 2d at 222)); Advanced
Comprehensive Lab’y, 2020 WL 7042648, at *8 (waiving the security requirement of Rule 65(c)
“in light of the systemic nature of the fraud alleged in the complaint and the lack of prejudice to
[the] defendants resulting from a preliminary injunction” (citing Mayzenberg, 2018 WL
6031156, at *10))); Moshe, 2020 WL 3503176, at *4 (“[The insurer] undoubtedly has the ability
to pay if [the] defendants prevail. As such, [the] defendants will suffer no harm from the

injunction and the bond requirement is waived.” (citing Wellmart, 435 F. Supp. 3d at 456));
Wellmart, 435 F. Supp. 3d at 456 (waiving security requirement “in light of the systemic nature
of the fraud alleged in the complaint and the lack of prejudice to defendants resulting from a
preliminary injunction”); Mayzenberg, 2018 WL 6031156, at *10 (waiving the security
requirement of Rule 65(c) where the court “concluded that a preliminary injunction will not
result in any prejudice to [the defendants] and would actually benefit them if all of their claims
are decided in one proceeding”).
III. Conclusion
For the foregoing reasons, the Court grants Plaintiffs’ motion. The Court stays all pending
no-fault insurance collection arbitrations and state court collections litigation commenced against
GEICO by or on behalf of Innovation Anesthesia, Chen, Liberty Park Chiro, Mangguray, Ciccone,
and JPM PT. The Court also enjoins all Defendants from commencing any new no-fault

insurance collection arbitrations or new no-fault insurance collections litigation against GEICO,
pending the resolution of GEICO’s claims in this action. The Court declines to require Plaintiffs
to post a bond.
Dated: March 25, 2025
Brooklyn, New York
SO ORDERED:

/s MKB
MARGO K. BRODIE
United States District Judge

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10830805. Public record. Not legal advice.