UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

MIAMI DIVISION

Case No.: 20-cv-22044-MARTINEZ/OTAZO-REYES

GOVERNMENT EMPLOYEES INSURANCE 

CO., GEICO INDEMNITY CO., GEICO 

GENERAL INSURANCE COMPANY and 

GEICO CASUALTY CO.,

Plaintiffs,

vs.

MANUEL FEIJOO, M.D., MANUEL V. 

FEIJOO, M.D. P.A., WE CARE MEDICAL 

SERVICES, INC, MANUEL MARTINEZ 

VARELA, TONY NGUYEN, D.O., NEW LIFE 

CLINICAL SERVICES, INC, ALEAN 

MACHADO, JOSE ESTEVEZ, YOANDRA 

RODRIGUEZ, ACCIDENT REHAB 

ASSOCIATES INC, d/b/a AMERICAN 

MEDICAL & REHAB CENTER, 

ALEJANDRO VAZQUEZ, MARIA 

VAZQUEZ, ERICK SALADO, M.D., MIAMI 

MEDICAL GROUP, INC, JUAN JIMENEZ, 

GRACIELA JIMENEZ, JOSE MARQUEZ, 

M.D., MARIA NODARSE, D.C., YARA 

VAZQUEZ, and HAI UZAN,

Defendants.

______________________________________/

PLAINTIFFS’ MEMORANDUM IN OPPOSITION TO DEFENDANTS’ MOTION TO

DISMISS AND ALTERNATIVE MOTION FOR A MORE DEFINITE STATEMENT

Plaintiffs, Government Employees Insurance Co., GEICO Indemnity Co., GEICO General 

Insurance Company and GEICO Casualty Co. (collectively “GEICO” or “Plaintiffs”) respectfully 

submit this memorandum in opposition to the motion by Defendants Miami Medical Group, Inc. 

(“Miami Medical”), Juan Jimenez (“J. Jimenez”), Graciela Jimenez (“G. Jimenez”), Jose Marquez 

M.D. (“Marquez”), Maria Nodarse, D.C. (“Nodarse”), Yara Vazquez (“Vazquez”), and Hai Uzan 

(“Uzan”)(collectively the “Miami Medical Defendants”), to dismiss Plaintiffs’ Complaint or, in 

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the alternative, for a more definite statement pursuant to Fed. R. Civ. P. 12(e). See Docket No. 

24.

1

SUMMARY

In its very detailed Complaint, GEICO alleges – in substance – that the Miami Medical 

Defendants, together with their co-Defendant Manuel Feijoo M.D. (“Feijoo”), submitted, or 

caused to be submitted, a massive amount of fraudulent no-fault (“no-fault”, “personal injury 

protection”, or “PIP”) insurance billing through Miami Medical to GEICO in violation of the 

Florida Health Care Clinic Act, Fla. Stat. § 400.990 et seq. (the “Clinic Act”). See Docket No. 1, ¶¶

1-80, 139-156, 285-331, 358-363, 701-872, and 873-884.

2

As discussed below, the Miami Medical Defendants’ arguments for dismissal ignore the 

detailed facts set forth in the Complaint and are at odds with the pertinent law, including the law 

that has developed in numerous, highly analogous no-fault insurance (“personal injury protection” 

or “PIP”) fraud cases in the 11th Circuit, in Florida state appellate courts, and across the country. 

Aside from their misleading recharacterization of GEICO’s allegations, the Miami Medical 

Defendants’ motion relies on an equally inaccurate interpretation of the pertinent law – including a

number of legal contentions that repeatedly have been raised in the past by defendants in 

 1 To the extent that the Miami Medical Defendants’ motion seeks a more definite statement, the 

Miami Medical Defendants failed to comply with Local Rule 7.1(a)(3). Local Rule 7.1(a)(3) 

requires a party contemplating a motion for a more definite statement to confer – or at least make 

a reasonable effort to confer – with the opposing party “in a good-faith effort to resolve by 

agreement the issues to be raised in the motion.” The Miami Medical Defendants did not contact 

Plaintiffs in any manner to discuss their supposed need for a more definite statement, as confirmed 

by the fact that the Miami Medical Defendants’ motion fails to include the certification required 

by Local Rule 7.1(a)(3). Standing alone, this warrants denial of their motion to the extent that it 

seeks a more definite statement. See, e.g., Local Rule 7.1(a)(3); see also Government Employees 

Ins. Co., et al. v. Alternative Medical Center of Florida, Inc., et al., S.D. Fla Case No. 1:17-cv21375-RNS, at Docket No. 17, pp. 2-3 (in extremely similar federal PIP fraud action, denying the 

defendants’ motion for a more definite statement where the defendants “failed to comply with 

Local Rule 7.1(a)(3), requiring that parties confer before filing a motion ... for a more definite 

statement.”)

2

These allegations are not pleaded in a conclusory vacuum, either. Rather, the Complaint sets forth 

numerous, claim-specific examples of the Miami Medical Defendants’ fraudulent 

misrepresentations and acts of fraudulent concealment, detailing the “who, what, when, where, and 

why” of a large number of the Miami Medical Defendants’ discrete fraudulent acts. See Docket No. 

1, ¶¶ 1-80, 139-156, 285-331, 358-363, 701-872, and 873-884, passim.

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substantially similar no-fault insurance fraud cases, and repeatedly rejected by the federal courts, 

including this Court. Indeed, the Miami Medical Defendantssomehow manage to avoid citing to any

of the many federal (and Florida appellate) decisions – in substantially similar anti-PIP fraud cases, 

including decisions by this Court – that decisively refute every one of their arguments. As discussed 

herein, the Miami Medical Defendants’ motion to dismiss therefore should be denied in its entirety.

BACKGROUND

GEICO commenced this action on May 15, 2020. See Docket No. 1. Because it is 

impossible to describe every aspect of the very detailed Complaint in a relatively brief 

memorandum of law, GEICO respectfully refers the Court to the Complaint for the full contours 

of Defendants’ interrelated fraudulent schemes. 

Briefly, however, the following is a summary:

(i) Pursuant to the Florida Motor Vehicle No-Fault Law (the “No-Fault Law”), in order 

for a healthcare service to be eligible for PIP reimbursement in Florida, it must be 

“lawfully provided”, meaning that it must be provided “in substantial compliance 

with all relevant applicable criminal, civil, and administrative requirements of state 

and federal law related to the provision of medical services or treatment.” See

Docket No. 1, ¶¶ 43-48, citing Fla. Stat. §§ 627.732, 627.736.

(ii) Pursuant to the Florida Health Care Clinic Act (the “Clinic Act”), clinics operating 

in Florida must – among other things – “appoint a medical director ... who shall 

agree in writing to accept legal responsibility for [certain enumerated] activities on 

behalf of the clinic.” See Docket No. 1, ¶¶ 49-58, citing Fla. Stat. § 

400.9935(1). Among other things, a clinic medical director must “[c]onduct 

systematic reviews of clinic billings to ensure that the billings are not fraudulent or 

unlawful. Upon discovery of an unlawful charge, the medical director ... shall take 

immediate corrective action.” Id. In addition, a clinic medical director must 

“[e]nsure that all practitioners providing health care services or supplies to patients 

maintain a current active and unencumbered Florida license”, and “[e]nsure that all 

health care practitioners at the clinic have active appropriate certification or 

licensure for the level of care being provided.” Id. Healthcare clinics that operate 

in violation of the Clinic Act’s medical director or other operating requirements are 

not eligible to collect PIP insurance benefits. Id., citing See Fla. Stat. § 400.9935(3). 

(iii) Thus, pursuant to both the Florida No-Fault Law and the Clinic Act, clinics that 

operate in violation of the Clinic Act’s medical director requirements are not 

entitled to collect PIP insurance benefits, whether or not the underlying healthcare 

services were medically necessary or actually provided. See Docket No. 1, ¶¶ 43-

58, see also Allstate Ins. Co. v. Vizcay, 826 F.3d 1326, 1330-1331 (11th Cir. 2016); 

State Farm Mut. Auto. Ins. Co. v. B&A Diagnostic, Inc., 145 F. Supp. 3d 1154, 

1164-1165 (S.D. Fla. 2015). 

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(iv) Pursuant to Florida’s No-Fault Law, insurers such as GEICO are only required to 

pay PIP insurance benefits for medically necessary services. See Fla. Stat. § 

627.736. Concomitantly, a healthcare services provider, including a clinic 

organized under the Clinic Act, is only eligible to receive PIP benefits for medically 

necessary services. See Docket No. 1, ¶¶ 69-70.

(v) Pursuant to Florida’s No-Fault Law, insurers such as GEICO also are not required 

to pay PIP benefits (a) for any service or treatment that is “upcoded”, meaning that 

it is billed using a billing code that would result in payment greater in amount than 

would be paid for a billing code that accurately described the services performed; 

(b) to any person who knowingly submits a false or misleading statement relating 

to the claim or charges; or (c) with respect to a bill or statement that does not 

substantially meet the billing requirements set forth in the No-Fault Law, including 

the requirement that the individual who personally performed or directly supervised 

the underlying healthcare service be identified on the bill. See Docket No. 1, ¶¶ 79-

80, 185-189, and passim; see also Fla. Stat. § 627.736(5)(b)(1).

(vi) In response to widespread PIP insurance fraud involving massage services and 

massage therapists, Florida’s no-fault insurance law was amended, effective 

January 1, 2013, to prohibit PIP reimbursement for massage or for services 

provided by unsupervised massage therapists. See Docket No. 1, ¶¶ 71-74; see also

2012 Fla. ALS 197 and Fla. Stat. § 627.736(1)(a)(5). In this context, pursuant to 

Fla. Stat. § 486.028, massage therapists may not practice physical therapy, or hold 

themselves out as being able to practice physical therapy, unless they have an actual 

license to practice physical therapy, as opposed to massage therapy. Id. Similarly, 

chiropractic assistants also lack the necessary license to perform physical therapy 

services without supervision. See Docket No. 1, ¶¶ 75-78.

(vii) J. Jimenez and G. Jimenez owned Miami Medical, and wanted to use Miami 

Medical – which was health care clinic – as a vehicle to submit a large volume of 

fraudulent PIP billing to GEICO and other insurers. See Docket No. 1, ¶¶ 139-156. 

However, J. Jimenez and G. Jimenez knew that if they recruited a legitimate 

physician to serve as Miami Medical’s legitimate medical director, any such 

physician would have to fulfill their statutory role as medical director, and would 

impede J. Jimenez and G. Jimenez’s ability to use Miami Medical as a vehicle to

submit fraudulent billing to GEICO and other insurers. Id. Accordingly, J. Jimenez 

and G. Jimenez recruited Marquez to falsely pose as medical director at Miami 

Medical. Id. In fact, Marquez did not legitimately fulfill his statutory duties as 

medical director, and instead unlawfully ceded day-to-day decision-making and 

oversight regarding healthcare services at Miami Medical, and the resulting billing, 

to J. Jimenez and G. Jimenez. Id. 

(viii) The vast majority of the healthcare services that were billed through Miami Medical 

to GEICO were purported physical therapy services. See Docket No. 1, ¶¶ 285-331. 

Miami Medical, J. Jimenez, G. Jimenez, Marquez, Nodarse, and Feijoo knew that, 

effective January 1, 2013, they could not bill GEICO for services performed 

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without supervision by G. Jimenez, Vazquez, and Uzan, who were massage 

therapists and/or chiropractic assistants. Id., ¶¶ 285-331. 

(ix) Accordingly – to conceal the fact that they were billing GEICO for services 

provided by unsupervised massage therapists and/or chiropractic assistants, 

including G. Jimenez, Vazquez, and Uzan – Miami Medical, J. Jimenez, G. 

Jimenez, Marquez, Nodarse, and Feijoo falsely represented, in all of the billing they 

submitted to GEICO for purported physical therapy services, that the pertinent 

services had been performed, or at least directly supervised, by Feijoo and/or 

Nodarse, and therefore were eligible for PIP reimbursement. Id., ¶¶ 285-331. In 

fact, the purported physical therapy services actually were performed by unlicensed 

massage therapists and/or chiropractic assistants (to the extent that they were 

performed at all), without any supervision by Feijoo, Nodarse, or any other licensed 

physician, chiropractor, or physical therapist, and therefore were not eligible for 

PIP reimbursement. Id.

(x) What is more, GEICO’s Complaint sets forth considerable, detailed facts to 

demonstrate that the Miami Medical Defendants routinely billed GEICO for 

medically unnecessary services or services that never actually were provided at all. 

See Docket No. 1, ¶¶ 701-872. These facts include: (a) numerous, claim-specific 

examples of instances in which the Miami Medical Defendants billed GEICO for 

relatively complex, lengthy, and detailed patient examinations, when in fact the 

examinations – to the extent that they were performed at all – were brief and 

perfunctory, with pre-determined and phony outcomes; (b) numerous claimspecific examples of instances in which two or more patients who were involved in 

the same accident “just happened” to present at Miami Medical on the exact same 

date after their accident, at which point Feijoo and/or Nodarse purported to examine 

them, gave them substantially identical phony “diagnoses”, and recommended a 

substantially identical, medically unnecessary “treatment plan” to them, despite the 

fact that the patients were differently situated; and (c) detailed allegations to 

demonstrate that the Miami Medical Defendants billed for the exact same types of 

medically unnecessary physical therapy services for virtually every patient, without 

regard for the patients’ true individual circumstances or presentation Id., passim. 

At bottom – and as alleged in granular detail in the Complaint – GEICO alleges that the 

Miami Medical Defendants pervasively billed inflated amounts for medically unnecessary and 

illusory services, unlawfully misrepresented the identities of the actual service providers, and 

concealed the fact that they were unlawfully billing GEICO for “physical therapy” services that 

were performed – to the extent that they were performed at all – by unsupervised massage

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therapists and/or chiropractic assistants, including G. Jimenez, Vazquez, and Uzan. See Docket 

No. 1, ¶¶ 1-80, 139-156, 151, 285-331, 701-872, 783-915, and 873-884, and passim.

3

Relatedly, GEICO alleges that Defendant Marquez never legitimately served as Miami 

Medical’s medical director because, had he done so, he would have observed and put an end to the 

pervasive fraud and unlawful activity. See Docket No. 1, ¶¶ 139-156, 285-331, 701-872, 783-915, 

1019-1020, and passim. By extension, GEICO alleges that all of the Miami Medical Defendants’ 

PIP billing falsely represented that Miami Medical was eligible to receive PIP reimbursement, 

when in fact Miami Medical was not eligible to receive PIP reimbursement because – in violation 

of the Clinic Act– it operated without a legitimate medical director who legitimately fulfilled his 

statutory duties as a clinic medical director. Id. 

Based on these allegations – which are pleaded in exacting detail, with many claim-specific 

examples of the Miami Medical Defendants’ fraudulent and unlawful activity – GEICO asserts 

claims against the Miami Medical Defendants for, variously, civil RICO violations under 18 

U.S.C. § 1962(c) and (d), violation of the Florida Deceptive and Unfair Trade Practices Act (the 

“FDUTPA”), violation of the Florida Civil Remedies for Criminal Practices Act (the “FCRCPA”), 

common law fraud, and unjust enrichment. Through these claims, GEICO seeks to recover the 

more than $1,400,000 it already has paid on the fraudulent billing that the Miami Medical 

Defendants submitted, or caused to be submitted, through Miami Medical. See Docket No. 1, ¶¶ 

1082-1133. In addition, GEICO seeks a declaratory judgment to the effect that it is not liable to 

pay any of the more than $75,000.00 in outstanding and unpaid billing that the Miami Medical 

Defendants submitted through Miami Medical, because of the fraud and unlawful conduct alleged 

in the Complaint. See Docket No. 1, ¶¶ 885-888.

ARGUMENT

I. The Miami Medical Defendants’ Motion Should be Denied to the Extent That it Seeks 

Dismissal of Plaintiffs’ Complaint Pursuant to Rule 12(b)(6)

As discussed below, none of the Miami Medical Defendants’ arguments for dismissal has 

any merit. Indeed, virtually identical anti-PIP fraud complaints asserting identical causes of action 

 3 As explained with great particularity in the Complaint, neither Feijoo nor Nodarse could possibly 

have performed or even supervised such a massive volume of “physical therapy” services, 

especially in light of their super-crowded work schedules. See Docket No. 1, passim.

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– and even anti- PIP fraud complaints with a substantially lesser amount of detail – repeatedly have 

been held sufficient by federal courts, both within and outside of the Eleventh Circuit.

A. Though the Miami Medical Defendants Attempt to Mischaracterize GEICO’s 

Allegations and the Pertinent Law Regarding Feijoo and Nodarse’s Failure to 

Supervise G. Jimenez, Vazquez, Uzan, and other Massage Therapists and/or

Chiropractic Assistants, GEICO’s Actual Allegations are Legally Sufficient and 

Totally Plausible

As set forth in GEICO’s Complaint, and as summarized above, Miami Medical, J. Jimenez, 

G. Jimenez, Marquez, Feijoo, Nodarse, Vazquez, and Uzan unlawfully billed GEICO for putative 

“physical therapy” services that were performed – to the extent that they were performed at all –

by G. Jimenez, Vazquez, Uzan, and other massage therapists and/or chiropractic assistants, who 

were unsupervised and who held no physical therapy licenses. To make it appear as if the services 

were eligible for PIP reimbursement, Miami Medical, J. Jimenez, G. Jimenez, Marquez, Feijoo, 

Nodarse, Vazquez, and Uzan falsely represented – in their billing for the services – that Feijoo 

and/or Nodarse personally performed or directly supervised the “physical therapy” services, which 

made it appear as if the purported services were eligible for PIP reimbursement, when in fact they 

were not. In fact – and as set forth in detail in GEICO’s Complaint – neither Feijoo nor Nodarse

could possibly have performed or even supervised the “physical therapy” services that were billed 

through Miami Medical to GEICO, especially considering their incredibly crowded work 

schedules and the superhuman amount of individual healthcare services that they both purported 

to perform on individual dates. See Docket No. 1, ¶¶ 139-156, 285-331, and passim.

In an attempt to rebut GEICO’s claims, the Miami Medical Defendants embark on a 

tortured analysis of the PIP statute and the Medicare Claims Processing Manual (the “Medicare 

Manual”). See Docket No. 24, pp. 9-16, and passim. Though it is difficult to follow their argument, 

the Miami Medical Defendants appear to contend that it was totally lawful for them to represent –

in their billing for the “physical therapy” services – that Feijoo and Nodarse supervised the 

services, because Feijoo and Nodarse supposedly provided some level of “general” or indirect 

supervision to G. Jimenez, Vazquez, Uzan, and other massage therapists and/or chiropractic 

assistants who performed the “physical therapy” services at Miami Medical. See id. 

If this is what the Miami Medical Defendants are driving at, they are incorrect. First, and 

most generally, the Miami Medical Defendants’ argument is at odds with the actual allegations in 

the Complaint, which are entitled to every favorable inference on this motion to dismiss. GEICO 

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not only alleges that Feijoo and Nodarse failed to “directly” supervise the purported physical 

therapy services, but GEICO very plausibly alleges that Feijoo and Nodarse failed to provide any

supervision with respect to the purported physical therapy services. See Docket No. 1, ¶¶ 285-331. 

Indeed, GEICO alleges detailed facts to demonstrate that Feijoo – who was purporting to work a 

superhumanly-crowded schedule, typically at multiple locations, on the same dates when he was 

purporting to oversee massive amounts of “physical therapy” at Miami Medical – could not 

possibly have supervised any of the purported physical therapy at Miami Medical. Likewise, 

GEICO alleges detailed facts to demonstrate that Nodarse also purported to work a superhumanlycrowded schedule – including at another health care clinic in addition to Miami Medical – on the 

same dates when she was purporting to oversee massive amounts of “physical therapy” at Miami 

Medical, and therefore could not possibly have supervised any of the purported physical therapy 

at Miami Medical4 Id. Accordingly, the Miami Medical Defendants’ “direct vs. general” 

supervision argument is a red herring.5

 4 The Miami Medical Defendants somehow assert that GEICO was deliberately vague in its 

allegations concerning the amount of services Nodarse purported to perform at Miami Medical 

and another health care clinic in Florida. See Docket No. 24, p.14-15. Contrary to this conclusory 

and baseless assertion, GEICO supported its allegations concerning the amount of healthcare 

services Nodarse purported to perform with granular detail. For instance, GEICO provided 

numerous detailed examples in which Nodarse purported to provide between at least 11 and 25

hours of health care services in a given day to GEICO insureds, alone, and specified where Nodarse 

purported to provide these massive amounts of healthcare services. See Docket No. 1, ¶¶ 303 (ix) . In this context, it is GEICO’s detailed allegations – and not the Miami Medical Defendants’ 

conclusory statements – that are entitled to the benefit of every reasonable inference on this motion 

to dismiss.

5 The Miami Medical Defendants incorrectly contend that, pursuant to Florida Law, “indirect 

supervision is expressly allowed for chiropractors (such as Nodarse) over registered chiropractic 

assistants(such as Yara Vazquez).” See Docket No. 24, p.16, fn. 5. This is false. It appears the 

Miami Medical Defendants confuse the supervision requirements necessary for a chiropractic 

assistant with that of a certified chiropractic physician assistant (emphasis added). While, in 

certain limited instances, Florida law allows for a chiropractor to provide only “indirect 

supervision” over services provided by a certified chiropractic physician assistant (see Fla. Sta. §

460.4165), that is not so for a chiropractic assistant. Indeed, as set forth in GEICO’s Complaint, 

(see Docket No. 1 ¶¶ 75-78), Florida law expressly requires a chiropractor, such as Nodarse, to 

“directly” supervise services provided by a chiropractic assistant. See Fla. Stat. § 460.4166(2). In 

this context, Vazquez is only licensed as a chiropractic assistant, not as a certified chiropractic 

assistant and thus Nodarse was required to “directly supervise” Vazquez. In any case, GEICO very 

plausibly alleges that Nodarse did not supervise Vazquez at all. 

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Second, and in any case, the Miami Medical Defendants’ strained analysis of the PIP 

statute and the Medicare Manual is at odds with the plain language of the Medicare Manual and 

the relevant law. As set forth in GEICO’s Complaint, the Miami Medical Defendants billed for all 

of their purported “physical therapy” services using HCFA-1500 forms, which had to be completed 

in accordance with the Medicare guidelines. See Docket No. 1, ¶¶ 44, 80, 285-331, and passim. 

Pursuant to the instructions promulgated by the Centers for Medicare & Medicaid Services for the 

completion of HCFA-1500 forms, to the extent that a physician is not actually “directly 

supervising” a physical therapy treatment, then the actual name of the person who is actually 

performing or directly supervising the physical therapy treatment must be listed on the HCFA1500 form. Id.

6

Though the Miami Medical Defendants struggle to find some ambiguity in the Medicare 

Manual, the Medicare Manual and the PIP statute are perfectly clear. So clear, in fact, that: (i) 

numerous federal courts within the 11th Circuit – including this Court – have sustained identical 

RICO and other fraud-based claims to the effect that a healthcare clinic billed for “physical 

therapy” performed by unsupervised masseuses, and then falsely represented in its HCFA-1500 

billing that a physician directly (or indirectly) supervised the masseuses; and (ii) the Florida Third 

District Court of Appeals recently denied PIP reimbursement to a healthcare clinic that falsely 

listed a physician on HCFA-1500 forms as the “direct supervisor” of purported physical therapy 

services, and unambiguously held that the Florida PIP statute precludes any reimbursement for 

any services that are performed by massage therapists. See, e.g., Government Employees Ins. Co., 

et al. v. Luis Lopez Mas, M.D. et al., S.D. Fla. Case No. 19-cv-21183-KMW, at Docket No. 71, 

pp. 7-13 (sustaining virtually identical PIP fraud and racketeering claims based on virtually 

identical allegations to the effect that defendants falsely represented, in their PIP billing, that a 

 6 See, e.g., Medicare Claims Processing Manual, Chapter 26 – Completing and Processing Form 

CMS-1500 Data Set, Item 31 (requiring that the “provider” or “supplier” of the underlying 

healthcare service, or its representative, sign in box 31 of a HCFA-1500 bill, and further providing 

that “In the case of a service that is provided incident to the service of a physician or nonphysician 

practitioner, when the ordering physician or non-physician practitioner is directly supervising the 

service as in 42 CFR 410.32, the signature of the ordering physician or non-physician practitioner 

shall be entered in item 31. When the ordering physician or non-physician practitioner is not 

supervising the service, then enter the signature of the physician or non-physician practitioner 

providing the direct supervision in item 31.”) 

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physician had supervised the “physical therapy” services at issue, when in fact the services had 

been performed by unsupervised massage therapists); Gov't Emples. Ins. Co. v. Quality Diagnostic 

Health Care, Inc., 369 F. Supp. 3d 1292, 1299-1301 (S.D. Fla. 2019)(Martinez, J.)(same)7; 

Government Employees Insurance Co. et al. v. DG Esthetic and Therapy Center, Inc. et al., S.D. Fla. 

Case No. 1:18-cv-20921-CMA, at Docket Nos. 21, 29, 31 (same); Government Employees Ins. Co., 

et al. v. Alternative Medical Center of Florida, Inc., et al., S.D. Fla Case No. 1:17-cv-21375-RNS, 

at Docket No. 17 (same); Gov't Emples. Ins. Co. v. A&C Med. Ctr. Servs., Corp., 2019 U.S. Dist.

LEXIS 133568 (S.D. Fla. 2019)(Martinez, J.)(same, although the Court ordered GEICO to file a 

shorter version of its complaint, and then ordered the Defendants to answer the amended complaint 

within 10 days – rather than file another motion to dismiss – “[b]because the Court rejects 

Defendants’ substantive arguments” for dismissal)8

; Geico Gen. Ins. Co. v. Beacon Healthcare Ctr.

Inc., 2020 Fla. App. LEXIS 2284 (Fla. 3d DCA 2020)(“the PIP statute . . . precludes 

 7 Notably, after this Court denied the Quality Diagnostic defendants’ motion to dismiss, it 

ultimately granted GEICO summary judgment on its fraud, FDUTPA, and unjust enrichment 

claims. See Gov't Emples. Ins. Co. v. Quality Diagnostic Health Care, 2019 U.S. Dist. LEXIS 

220674 (S.D. Fla. 2019). Thereafter, the Quality Diagnostic defendants moved to vacate or alter 

the judgment. See Quality Diagnostic, S.D. Fla. Case No. 1:18-cv-20101-JEM, at Docket No. 152. 

In their motion to vacate or alter the judgment, the Quality Diagnostic defendants raised – among 

other things – the exact same arguments as the Miami Medical Defendants in the present case, to 

the effect that “direct” supervision by a licensed physician is not required, and a healthcare clinic 

may lawfully bill for “physical therapy” services performed by a massage therapist, so long as the 

massage therapist was “indirectly” or generally supervised by a licensed physician. See id., pp. 2-

6. GEICO opposed the Quality Diagnostic defendants’ motion to vacate or alter the judgment, 

noting – just as it has in the present case – that there is no legal authority to support that proposition, 

which in any event is contrary to common sense. See Quality Diagnostic, at Docket No. 163, pp. 

12-14. Though this Court ultimately denied the Quality Diagnostic defendants’ motion to vacate 

or alter the judgment because it was procedurally improper, this Court also “agree[d] with 

Plaintiffs that the Motion is meritless ... .” See Quality Diagnostic, at Docket No. 165.

8 GEICO is aware of the fact that its Complaint in the present case – like its complaint in the A&C

Med. Ctr. Case – is lengthy and detailed. GEICO respectfully submits that the length and detail

are warranted by: (i) the multifaceted nature of the alleged fraud; (ii) the number of interrelated

Defendants; and (iii) the need to plead the fraud-based claims in accordance with Rule 9(b). As set

forth herein, numerous courts in the 11th Circuit have sustained PIP fraud and rackeering

complaints pleaded in a similar manner, with a similar length and level of detail. However, to the

extent that the Court finds it warranted, GEICO is prepared to file a shorter version of its

Complaint. If the Court orders GEICO to file a shorter version of the Complaint, GEICO

respectfully submits that – as in the A&C Med. Ctr. case – the Court should order the Defendants

to answer the Complaint, rather than file further motions to dismiss.

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reimbursement [for] massage therapists” who are performing physical therapy services); see also

S. Owners Ins. Co. v. Hendrickson, 2020 Fla. App. LEXIS 6631 (Fla. 5th DCA 2020), where the 

court reached the same conclusion as in Beacon and held that the PIP statute “precludes a licensed 

massage therapist from being reimbursed for medical benefits”. Id. at *2.

Not only is the Miami Medical Defendants’ “direct vs. general” supervision at odds with 

the actual allegations in the Complaint, and the weight of federal authority sustaining virtually 

identical PIP fraud claims based on virtually identical allegations, but it also is at odds with basic 

common sense. At bottom, if the Court were to credit the Miami Medical Defendants’ “general” 

or indirect supervision argument, then it would mean that a single physician could stand in the 

middle of downtown Miami with a cellphone in his or her hand, “generally supervise” hundreds –

or even thousands – of individual massage therapists performing physical therapy services within 

a 20-mile or 30-minute radius of that spot, and have those services be considered part of the 

physician’s practice of medicine, rather than noncompensable massage. This is not the law, and 

the Court should decline the Miami Medical Defendants’ invitation to create such a rule.

B. The Miami Medical Defendants’ “Reliance” Argument is Meritless

The Miami Medical Defendants go on to argue that GEICO’s Complaint should be 

dismissed because GEICO did not justifiably rely on any misrepresentations.

9 See Docket No. 24,

pp. 18-19 and passim. At bottom, the Miami Medical Defendants posit that, because GEICO 

supposedly knew (or at least had inquiry notice) that the billing submitted by the Miami Medical 

Defendants was fraudulent, but paid the charges anyway, GEICO’s reliance could not have been 

justifiable. Id.

 9

The Miami Medical Defendants do not articulate which counts they seek to dismiss based on their 

“justifiable reliance” argument. To the extent the Miami Medical Defendants are using the 

“justifiable reliance” argument to seek dismissal of GEICO’s FDUTPA and unjust enrichment 

claims, the court should reject this argument because reliance is not an element of FDUTPA or 

unjust enrichment claims. See, e.g., State Farm Mut. Auto. Ins. Co. v. B&A Diagnostic, Inc., 145 F. 

Supp. 3d 1154, 1165 (S.D. Fla. 2015)(“Under Florida law, the elements of a cause of action for 

unjust enrichment are: (1) plaintiff conferred a benefit on a defendant who has knowledge of that 

benefit; (2) defendant accepted and retained the benefit and (3) under the circumstances, it would be 

inequitable for the defendant to retain the benefit without paying for it.”)(Internal quotations and 

citation omitted); Carriuolo v. GM Co., 823 F.3d 977, 985 (11th Cir. 2016)(“[A] plaintiff asserting a 

FDUTPA claim need not show actual reliance on the representation or omission at issue 

....”)(Internal quotations and citation omitted).

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The Miami Medical Defendants are incorrect, for several reasons. First, and most 

generally, reliance is a fact-intensive issue that is not properly resolved on a motion to dismiss 

pursuant to Rule 12(b)(6). See, e.g., Luis Lopez Mas, supra, at Docket No. 71, pp. 14-17 (rejecting 

identical “reliance” argument, in a substantially similar PIP fraud and racketeering case, and 

holding that “it is inappropriate at this juncture to decide as a matter of law exactly when GEICO 

would have been on notice of any fraud, a highly fact intensive inquiry best reserved for a trier of 

fact at trial.”)(Internal quotations omitted); Maze Partners v. First Choice Healthcare Solutions,

2019 U.S. Dist. LEXIS 184611 at * 48 (M.D. Fla. 2019)(element of reasonable reliance ordinarily 

is a fact-intensive issue not proper for determination as a matter of law at the pleading stage, but 

one more appropriate for the fact-finder after discovery has developed a sufficient evidentiary 

record); Doe v. Royal Caribbean Cruises, Ltd., 2011 U.S. Dist. LEXIS 146855 at * 9 (S.D. Fla. 

2011)(whether plaintiff’s reliance was reasonable in light of the defendant’s actions was not a 

question that could be resolved on a motion to dismiss pursuant to Rule 12(b)(6)). In this context, 

it would be especially inappropriate to dismiss based on the Miami Medical Defendants’ reliance

argument, because the argument is predicated on conclusory speculation about what GEICO knew, 

and when GEICO knew it. In actuality, GEICO has pleaded facts to demonstrate that the Miami 

Medical Defendants acted to conceal their interrelated fraudulent schemes, that GEICO was under 

statutory and contractual obligations to promptly and fairly process claims within 30 days, and that 

the facially-valid documents submitted to GEICO in support of the fraudulent charges at issue, 

combined with the material misrepresentations and acts of concealment described above, were 

designed to and did cause GEICO to rely upon them. See Docket No. 1, ¶¶ 875-884, and passim. 

It is GEICO’s detailed allegations – and not the Miami Medical Defendants’ conclusory statements 

– that are entitled to the benefit of every reasonable inference on this motion to dismiss. 

Second, and in any case, GEICO was entitled – as a matter of law – to rely on the 

representations in the Miami Medical Defendants’ PIP claims, as this Court itself has observed. 

See, e.g., Government Employees Ins. Co., et al. v. Quality Diagnostic Health Care, Inc., et. al, S.D. 

Fla. Case No. 18-cv-20101-JEM, at Docket No. 125, p. 18 (rejecting similar “reliance” arguments 

in context of summary judgment motions, and noting that “GEICO was entitled to rely upon 

Defendants’ PIP claims”); Peak Prop. & Cas. Ins. Corp. v. Enskin, 2014 U.S. Dist. LEXIS 69780 

(M.D. Fla. 2014)(“As a matter of law, the insurer is entitled to rely on the representations made by 

an applicant in the application for insurance.”); Suite 225, Inc. v. Lantana Ins., Ltd., 2013 U.S. 

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Dist. LEXIS 190536 at * 17 (S.D. Fla. 2013)(“It is well settled that the insurer is entitled to rely

on the representations of an insured, without checking all its files to determine if the insured is 

committing a fraud.”)(Internal quotations and citations omitted). Were it otherwise, then every 

fraudulent PIP claimant would have a complete defense to a plaintiff-insurer’s fraud claim simply 

by virtue of the fact that the insurer paid the claim.

Third, in keeping with the fact that GEICO was entitled to rely on the representations in 

the Miami Medical Defendants’ PIP claims, the No-Fault Law explicitly permits plaintiff-insurers 

to challenge fraudulent or unlawful PIP claims at any time, even after they are paid. See Fla. Stat. 

§ 627.736(4)(b)(6)(permitting insurers to assert that PIP claims were medically unnecessary, 

fraudulent, unlawful, upcoded, etc., “at any time, including after payment of the claim”).10

Accordingly, the Miami Medical Defendants’ “reliance” argument is meritless, and their 

motion to dismiss should be denied. 

C. The Miami Medical Defendants’ FDUTPA and “Reasonableness” Arguments are 

Meritless

Along similar lines, the Miami Medical Defendants contend – in totally conclusory fashion 

– that GEICO’s FDUTPA claims should be dismissed because GEICO supposedly has not 

sufficiently alleged that the Miami Medical Defendants’ deceptive practices would be likely to 

deceive a reasonable consumer. See Docket No. 24, pp. 16-17. Again, however, questions 

regarding whether a reasonable consumer would be deceived by the Miami Medical Defendants’ 

deceptive practices are not properly resolved via a motion to dismiss pursuant to Rule 12(b)(6). In 

the present case, GEICO not only has alleged that the Miami Medical Defendants made various 

misrepresentations in connection with their PIP billing, but also that the Miami Medical 

Defendants’ PIP charges were facially-valid and that GEICO had only 30 days to process the 

Miami Medical Defendants’ claims. See Docket No. 1, ¶¶ 875-884, and passim. In this context –

 10 There are obviously sound public policy reasons for this provision, and the Miami Medical 

Defendants’ baseless assertion that GEICO has waived its right to challenge the claims at issue in 

this lawsuit because it has already paid them is not only belied by the statute but also the federal 

courts that have considered this issue and which are referenced throughout the body of this 

complaint.

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especially on a motion to dismiss where GEICO is entitled to every favorable inference – the Court

should not resolve the “reasonable consumer” issue at the pleading stage.11

Indeed, it is worthwhile to note that courts within the 11th Circuit have denied motions to 

dismiss plaintiff-insurers’ FDUTPA claims that were predicated on substantially identical facts, as 

set forth in complaints that were in all material respects substantially identical to the Complaint in 

the present case. See, e.g., Alternative Medical Center of Florida, Inc., supra, at Docket No. 17 

(denying motion to dismiss virtually identical FDUTPA claim in substantially identical complaint 

alleging upcoded examination charges/billing for unsupervised massage therapists); DG Esthetic, 

supra at Docket No. 29 (same); Luis Lopez Mas, M.D., supra at Docket No. 71, p. 16 (same, and 

rejecting a “reasonable consumer” argument that is identical to the argument raised by the Miami 

Medical Defendants herein); State Farm Mut. Auto. Ins. Co. v. Physicians Group of Sarasota, 

L.L.C., 9 F. Supp. 3d 1303, 1312-1313 (M.D. Fla. 2014)(observing that the FDUTPA is to be 

“liberally construed”, and rejecting motion to dismiss plaintiff-insurer’s FDUTPA claims based 

on an automobile insurance fraud scheme).

D. GEICO Has Pleaded its Fraud-Based Claims with the Requisite Specificity

The Miami Medical Defendants also argue that GEICO’s fraud-based claims are not 

pleaded with the requisite particularity under Rule 9(b). See Docket No. 24, pp. 7-8, 16-17, and 

passim. The Miami Medical Defendants are incorrect, and ignore the weight of authority from 

district courts within the 11th Circuit, in which anti-PIP fraud complaints with a virtually identical, 

or even lesser, amount of detail were held sufficient under Rule 9(b).12 See, e.g., DG Esthetic, 

 11 For their FDUTPA/reasonableness arguments, The Miami Medical Defendants rely on CluckU Chicken, Inc. v. Cluck-U Corp., , 2017 WL 10275957, at *9 (M.D. Fla. June 6, 2017), and Deere 

Constr., LLC v. CEMEX Constr. Materials Fla., LLC, 2016 WL 8542540, at *3 (S.D. Fla. Dec. 1, 

2016), cases that involved a motion for summary judgment and a motion for class certification 

respectively, and are otherwise inapposite cases. See Docket No. 24, p. 17. Beyond just citing to 

these cases for the purposes of introducing the general, “reasonable consumer” standard on 

FDUTPA claims, The Miami Medical Defendants do not even attempt to articulate how these 

cases have any relevance or present any guidance with respect to the present motion. 

12The Miami Medical Defendants’ reference to State Farm v. Feijoo, et. al., 18-cv-23329, ECF 

Doc. No. 56 is inapposite. See Docket No. 24, pp. 16-17. While the Feijoo court dismissed the 

plaintiff-insurer’s claims for being insufficiently specific under Rule 9(b), GEICO’s Complaint in 

the present case is much more detailed and particular than the State Farm v. Feijoo complaint , and 

easily meets the Rule 9(b) standard. As set forth herein, every federal court, both in this district 

and others, have held that anti-PIP fraud complaints pled in a virtually identical matter to this one 

met the Rule 9(b) pleading standard.

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supra at Docket Nos. 21, 22, 29 (denying motion to dismiss GEICO’s fraud-based claims – which 

were pleaded with an identical level of detail as the allegations in the present case – based on 

argument that the complaint was insufficiently particularized under Rule 9(b)); Luis Lopez Mas, 

M.D., supra at Docket No. 71 (same); Alternative Medical Center of Florida, Inc., supra at Docket 

No. 17, p. 5 (holding that “GEICO’s comprehensive and granularly specific 119-page complaint” 

– which was pleaded with a format and level of detail that is virtually identical to the Complaint 

in the present case – “sufficiently states a cause of action for each of its seven counts.”); 

Government Employees Insurance Co. et al v. Path Medical, LLC et al, M.D. Fla. Case No. 8:17-

cv-02848-EAK-TGW, Docket No. 112, pp. 15-18 (sustaining fraud-based claims on allegations 

with a similar level of detail in PIP fraud case and noting – among other things – that “[t]he 

complaint details the [] [d]efendants’ individual roles in the fraudulent scheme, explains how each 

of the [] [d]efendants’ actions furthered the scheme ... [t]he complaint contains numerous 

examples of the arrangement in support ... [f]urthermore, through the attached exhibit, GEICO 

provides a comprehensive listing of the bills submitted to GEICO as a result of the fraud ... .”); 

Gov't Emples. Ins. Co. v. KJ Chiropractic Ctr. LLC, 2014 U.S. Dist. LEXIS 28913 at *18 n.4 

(M.D. Fla. 2014)(GEICO stated fraud claims in anti-PIP fraud case where it set forth the “‘who, 

what, when, and where’ of the alleged scheme, including specific claim numbers, dates of loss, 

which clinic submitted bills, amounts paid by GEICO as well as type of fraud, date of mailing/wire, 

specific misrepresentations made, and parties who submitted the documents.”).

At bottom, any fair reading of the Complaint should leave the respective Miami Medical 

Defendants with no doubt as to their individual roles in the fraudulent scheme. For example, and 

as discussed above, the Miami Medical Defendants are alleged to have acted together to submit 

the fraudulent billing through Miami Medical to GEICO, with J. Jimenez, G. Jimenez, and 

Marquez directing the affairs of the Miami Medical enterprise, Marquez falsely posing as the 

“medical director” of the Miami Medical enterprise, Feijoo and Nodarse falsely purporting to 

supervise a superhuman amount of “physical therapy” services, G. Jimenez, Vazquez, and Uzan

performing healthcare services at Miami Medical without the appropriate supervision, and all of 

the Miami Medical Defendants acting together to cause the fraudulent billing for those services to 

be submitted to GEICO. See Docket No. 1, ¶¶ 1-80, 139-156, 285-331, 701-872, 783-915, and 

873-884. This is more than sufficient to satisfy Rule 9(b). 

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E. GEICO Has Sufficiently Alleged its Claims Against Vazquez and Uzan

Relatedly, the Miami Medical Defendants argue that GEICO’s claims against Vazquez and 

Uzan should be dismissed for lack of particularity, and because GEICO supposedly has not alleged 

any facts to show that Vazquez and Uzan “ever made a single false representation... or had any role 

or responsibility for creating and submitting the HCFA forms.”. See Docket No. 24, p. 19, and 

passim. 13

Again, the Miami Medical Defendants are incorrect. As discussed above, any fair reading of 

GEICO’s Complaint should leave the Miami Medical Defendants in no doubt as to what each of 

them is alleged to have done. With respect to Vazquez and Uzan, the Complaint clearly alleges that 

Vazquez and Uzan performed medically unnecessary “physical therapy” services, with the 

knowledge that the resulting bills would falsely represent: (i) that the “physical therapy” was 

medically necessary; and (ii) that they both had been supervised by a licensed physician or 

chiropractor when performing the “physical therapy”; and (iii) that the “physical therapy” therefore 

was eligible for PIP reimbursement, when in fact it was not. See Docket No. 1, ¶¶ 139-156, 285-

331, 908-915, 873-884, and passim. What is more, the Complaint identifies the billing codes used 

to bill for Vazquez and Uzan’s fraudulent services, and the spreadsheet attached as Exhibit “5” to 

the Complaint set forth a large, representative sample of the predicate acts of mail fraud in which 

Vazquez and Uzan – together with their co-Defendants – engaged.

This is sufficient at the pleading stage. See, e.g., KJ Chiropractic Ctr. LLC, supra at *13 

(M.D. Fla. 2014)( “Although GEICO has lumped the Defendants together in certain portions of the 

Second Amended Complaint, this does not negate the fact that GEICO has still alleged specific 

instances of conduct sufficient to inform each Defendant of its individual role in the alleged 

scheme.”); Government Employees Insurance Co. et al v. Cereceda, et al., S.D. Fla. Case No. 19-

cv-22206, at Docket Nos. 57, 72 (in case featuring very similar anti-PIP fraud complaint, pleaded 

with the same level of particularity as GEICO’s Complaint in the present case, denying motion to 

dismiss where defendants similarly argued that GEICO had not sufficiently pleaded fraud claims 

against the employees of health care clinics); Orthopedic Rehab Specialty Clinics, Inc. v. State Farm 

 13 The Miami Medical Defendants also cite to Brooks v. Blue Cross and Blue Shield of Florida, 

Inc., 116 F.3d 1364, 1380–81(11th Cir.1997) in what appears to be a misguided attempt to make 

a “group pleading” argument. See Docket No. 24, pp.20-21. For the reasons set forth below, the 

Miami Medical Defendants’ arguments are again baseless.

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Mut. Auto. Ins. Co., 2003 U.S. Dist. LEXIS 29312 at * 8 - * 9 (M.D. Fla. 2003)(rejecting similar 

“group pleading” argument, where insurer/counterclaim-plaintiff alleged that various counterclaimdefendants acted collectively to cause the submission of fraudulent billing, because “such allegations 

are sufficient at the pleading stage to put the Counter-Defendants on notice of their alleged fraudulent 

conduct.”); DG Esthetic, supra (denying motion to dismiss substantially similar complaint with 

virtually identical level of detail, pleaded in a substantially identical manner); Luis Mas, M.D., supra

(finding a similar “group pleading” argument unpersuasive and held that while “GEICO lumped the 

Defendants together in certain portions of [the Complaint], this does not negate the fact that 

GEICO has still alleged specific instances of conduct sufficient to inform each Defendant of its 

individual role in the alleged scheme.”)

In this context, while it is true enough the GEICO does not allege that Vazquez and Uzan

personally dropped a fraudulent PIP bill into the mailbox, GEICO is not obligated to make such 

allegations, considering Vazquez and Uzan’s well-pleaded role as two of the primary providers of 

the fraudulent services in Miami Medical’s fraudulent scheme. See, e.g., State Farm Mut. Auto. Ins. 

Co. v. Physicians Group of Sarasota, L.L.C., at Docket No. 5, pp. 15-18, and 9 F. Supp. 3d at 1311 

(though defendants in a highly-analogous PIP fraud case made similar arguments, the Court 

nonetheless held that the plaintiff-insurer’s complaint, which contained a level of detail similar to 

GEICO’s Complaint in the present case, satisfied Rule 9(b)); Cereceda, supra (same); State Farm 

Mut. Auto. Ins. Co. v. Kugler, 2011 U.S. Dist. LEXIS 107005 at * 17 - * 18 (S.D. Fla. 2011) (though 

defendants in PIP fraud case made similar arguments, the court nonetheless held that the plaintiffinsurer’s complaint, which contained a level of detail similar to GEICO’s Complaint in the present 

case, satisfied Rule 9(b)).

II. The Miami Medical Defendants’ Motion Should be Denied to the Extent That it Seeks 

a More Definite Statement Pursuant to Rule 12(e)

As a threshold matter, and as noted above, the Miami Medical Defendants’ failure to 

comply with Local Rule 7.1(a)(3) – standing alone – warrants denial of their motion to the extent 

that it seeks a more definite statement. See, e.g., Alternative Medical Center of Florida, Inc., supra

(in extremely similar federal PIP fraud action, denying motion for a more definite statement “on 

this basis alone.”).

Even if the Court were to consider the Miami Medical Defendants’ Rule 12(e) motion 

despite their failure to comply with the Local Rules, the motion still should be denied. “A party 

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may move for a more definite statement of a pleading to which a responsive pleading is allowed 

but which is so vague or ambiguous that the party cannot reasonably prepare a response.” Poling 

v. Pristine Nutraceuticals, LLC, 2015 U.S. Dist. LEXIS 187949 at * 1 - * 2 (S.D. Fla. 2015), 

quoting Fed. R. Civ. P. 12(e). In this context, “[a] motion for a more definite statement is intended 

to provide a remedy for an unintelligible pleading, rather than a vehicle for obtaining greater 

detail.” Id. (internal quotations and citations omitted). In fact, “Rule 12(e) motions are generally 

disfavored because too often defendants argue that a more definite statement is needed simply to 

delay the progress of the plaintiff's case.” U.S. Specialty Ins. Co. v. Jet One Express, Inc., 2013 

U.S. Dist. LEXIS 95481 at * 5 (S.D. Fla. 2013). More generally, Rule 12(e) motions “should not 

be used as a means of discovery.” Rodriguez v. Carrot Express Midtown, LLC, 2019 U.S. Dist. 

LEXIS 222187 at *6 (S.D. Fla. Dec. 30, 2019).

Against this backdrop, the Miami Medical Defendants do not identify any portion of 

GEICO’s Complaint that is so vague or ambiguous that they cannot reasonably prepare a response. 

See Docket No. 24, passim. Either Miami Medical was unlawfully operated without a legitimate 

medical director in violation of the Clinic Act, or it was lawfully operated in compliance with the 

Clinic Act. Either the putative healthcare services that were billed through Miami Medical to GEICO 

were “lawfully provided” and medically necessary, or they were not. Either the Miami Medical 

Defendants illegally billed GEICO for physical therapy services provided by an unsupervised 

massage therapist and/or chiropractic assistant – and falsely represented in the billing that the 

masseuse and chiropractic assistant worked under the direct supervision of a licensed physician – or 

they did not. Either the numerous, claim-specific examples of the Miami Medical Defendants’ 

fraudulent treatment and billing practices that are set forth in the Complaint are accurate, or they are 

not. 

Simply put, GEICO’s Complaint presents a straightforward, easily understandable narrative 

setting forth detailed facts regarding the Miami Medical Defendants and their fraudulent activities. 

See Docket No. 1, passim. Indeed – and as discussed above – GEICO’s Complaint in this action is 

sufficiently detailed and clear to withstand a motion to dismiss pursuant to Fed. R. Civ. P. 12(b)(6) 

and 9(b), let alone a motion for a more definite statement. 

The Miami Medical Defendants’ contention that GEICO’s complaint is somehow 

unintelligible because it uses phrases such as “in many cases” and “to the extent the services were 

provided at all” is belied by two recent decisions from this district in which motions for a more 

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definite statement were denied. See Docket No. 24, pp. 23-24. Both cases – Gov't Emples. Ins. Co. 

v. Benefica Health Ctr., Corp., 2017 U.S. Dist. LEXIS 66542 (S.D. Fla. 2017) and Alternative 

Medical Center of Florida, Inc., supra – involved substantially similar PIP fraud complaints, 

featuring substantially similar allegations and a virtually identical format and level of detail.14 In 

Benefica, the Honorable Federico A. Moreno denied the defendants’ motion for a more definite 

statement under Rule 12(e). As Judge Moreno observed:

The amended complaint provides more than adequate information for Defendants to 

respond in good faith. Defendants are on clear notice of their alleged fraudulent conduct as 

the amended complaint alleges, inter alia, that Benefica was unlawfully operating without 

a legitimate medical director; that the putative health care services billed through Benefica

were fraudulent; and that Defendants illegally billed GEICO for services. The amended 

complaint is not unintelligible. To the contrary, although it does not specify all allegedly 

fraudulent reimbursement claims, it provides thousands of examples, each containing 

Benefica's claim number, the date received, CPT code, and purported date of service. To 

the extent any allegations are unclear due to a lack of specificity, they are more 

appropriately clarified by discovery.

Id. at *5; see also Alternative Medical, supra, Docket No. 17, fn. 1 (denying motion for more 

definite statement based – as in the present case – on the defendants’ failure to meet and confer as 

required by the local rules, but noting, in any case, that “had the Court assessed Alternative 

Medical’s motion for a more definite statement on its merits it likely would have reached the same 

conclusion: the complaint ‘provides more than adequate information for Defendants to respond’ 

and is far from unintelligible.”)

GEICO’s Complaint is in all material respects identical to the complaints in Benefica and 

Alternative Medical. Therefore, GEICO respectfully submits that the present motion for a more 

definite statement should be denied for the same reasons that Judge Moreno denied the Benefica

defendants’ motion for a more definite statement.

 14 For example – and as in the present case – in both the Benefica case and the Alternative Medical 

Center of Florida case, GEICO alleged that the defendant healthcare clinics and their associates 

submitted fraudulent billing for physical therapy services that unlawfully were performed by 

unsupervised massage therapists, falsely represented in the billing that a licensed physician had 

either personally performed or directly supervised the physical therapy services, and falsely 

represented that the services were medically necessary, and in some cases that the services actually 

had been performed. By extension, in both the Benefica case and the Alternative Medical Center 

of Florida case – as in the present case – GEICO alleged that the defendant healthcare clinics 

lacked legitimate medical directors, and therefore were operating in violation of the Clinic Act.

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Accordingly, the Miami Medical Defendants’ motion should be denied to the extent that it 

seeks a more definite statement.

III. To the Extent That the Court Finds any Defect, GEICO Requests Leave to Replead

GEICO believes that its Complaint adequately alleges its claims against the Defendants. To 

the extent, however, that the Court finds the Complaint to be inadequate in any manner, GEICO 

respectfully requests leave pursuant to Fed. R. Civ. Proc. 15(a) to serve an amended complaint, as it 

believes that any such inadequacies would be merely issues of technical pleading rather than 

substantive defects in the claims. When a party requests leave to amend its complaint, permission 

generally should be freely granted. See, e.g., Chrystall v. Serden Techs., Inc., 2011 U.S. Dist. LEXIS 

144613 at *18 (S.D. Fla. 2011)

CONCLUSION

For the reasons stated above, the Miami Medical Defendants’ motion to dismiss and 

alternative motion for a more definite statement should be denied in its entirety.

Respectfully submitted,

/s/ John P. Marino

John P. Marino (FBN 814539) 

Lindsey R. Trowell (FBN 678783)

Kristen L. Wenger (FBN 92136)

SMITH, GAMBRELL & RUSSELL, LLP 

50 North Laura Street, Suite 2600

Jacksonville, Florida 32202

Phone: (904) 598-6100

Facsimile: (904) 598-6204

ltrowell@sgrlaw.com

jmarino@sgrlaw.com

kwenger@sgrlaw.com

Yonatan Bernstein (admitted pro hac vice)

RIVKIN RADLER LLP

926 RXR Plaza

Uniondale, New York 11550 

Phone: (516) 357-3000

Facsimile: (516) 357-3333

yonatan.bernstein@rivkin.com 

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CERTIFICATE OF SERVICE

I certify that on July 22, 2020, I electronically filed the foregoing document with the Clerk 

of the Court using the CM/ECF system, which will provide notice and a copy of the foregoing to 

the counsel of record in this case. 

/s/ John P. Marino 

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