GEICO filed a federal complaint against ROM DME Inc. and its owner, Avraam Shimonov, alleging a No-Fault kickback scheme that inflated prescriptions and billing amounts. Court records claim ROM DME billed GEICO for more than $1.2 million between March 2024 and February 2025, with GEICO paying more than $1 million before disputing additional charges. GEICO contests roughly $500,000 in pending claims and seeks a court declaration that it owes nothing further. The complaint alleges prescriptions were stamped, photocopied, or electronically generated, and delivery receipts contained inconsistencies in patient signatures. It also cites specific billing code examples, including alleged upcoding for higher-paying items and mismatches between billed products and what patients reportedly received. The lawsuit includes six causes of action, including civil RICO, and seeks damages.
"GEICO has hauled a Queens-based medical equipment supplier into federal court, accusing the company of juicing prescriptions and puffing up bills in a No-Fault kickback scheme that allegedly churned out more than $1.2 million in charges, according to court records. The May 26, 2026 complaint, filed in the U.S. District Court for the Eastern District of New York, names ROM DME Inc. and its owner, Avraam Shimonov, as defendants."
"As reported by Insurance Business, ROM DME allegedly billed GEICO for more than $1.2 million between March 2024 and February 2025, with the insurer paying out in excess of $1 million before hitting the brakes. GEICO is now contesting roughly $500,000 in additional pending claims and is asking the court to declare that it does not have to pay those bills at all."
"The complaint, summarized by Insurance Business, claims prescriptions were "stamped, photocopied, and/or electronically generated," while delivery receipts supposedly showed "glaring inconsistencies" in patient signatures. The filing drills into specific HCPCS billing examples that GEICO flags as suspicious."
"According to the lawsuit, ROM DME allegedly selected higher-paying codes for vague prescriptions, such as billing L0650 at $563.60. In another example, the company is accused of listing an egg-crate mattress under code E0272 at $118.19 when patients allegedly received a topper reimbursable at $19.48. GEICO also says ROM DME billed T5001 for an "orthopedic car seat" at $574.58 while patients reportedly received positioning cushions reimbursable at about $22.04."
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