Pro-choice statute does not apply to medical fraud case against GEICO

After the public learned that the Supreme Court was about to overturn Roe v. Wade, the seminal abortion rights decision, New York enacted a law that makes it illegal to burden the rights protected by New York law. The context was reproductive rights. This lawsuit implicates that statute, but the plaintiff loses.

The case is Clarke v. GEICO, a summary order issued on January 5. In early 2022, someone leaked the ruling in Dobbs v. Jackson Women's Health Organization, which said the Constitution does not protect the right to an abortion. Dobbs overruled Roe. New York responded by passing the Freedom from Interference with Reproductive and Endocrine Health Advocacy and Travel Exercise Act, or the FIRE HATE Act. The legislation was directed at the "risk of civil actions and criminal actions brought in courts outside the state of New York seeking to punish or impose civil liability on individuals traveling to New York" to access an abortion.

In this case, GEICO, the insurance company, brought two civil RICO actions against plaintiff, a doctor, in the Eastern District of New York, alleging that he worked with a medical equipment company to fraudulently bill for unnecessary medical equipment in no-fault insurance claims. So the RICO action involved alleged fraud in medical care. In defending the case GEICO claimed the STOP HATE Act involves "medical care" relating to reproductive or gender-affirming medical care, not unrelated medical treatment.

This is a statutory interpretation case. After reviewing this relatively recent statute, the Court of Appeals (Menashi, Robinson and Perez) holds that plaintiff cannot proceed with this case because the GEICO lawsuits "did not seek to impose liability on Clarke for the provision of medical care -- of any kind -- and therefore the lawsuits did not 'result' from the provision of medical care." This case involves GEICO's lawsuit against plaintiff over alleged false billing for payment rather than his provision for medical care. The Court reasons, "The provision of medical care was not even a but-for cause of the litigation: Clarke could have submitted false bills before he provided the related medical care—and he could have submitted false bills without providing any medical care at all. The actual cause of the litigation was his purported false billing practices rather than his provision of medical care."