The attorneys at Leader & Berkon LLP — the law firm representing Guardian — sought a deposition of Mr. Zaher late last year, but, after initially granting a temporary restraining order in preventing the deposition from going forward, the court subsequently granted them a very limited deposition. On January 28, the deposition was held, during which the attorney representing Guardian continuously sought to go beyond the limited scope authorized by the court and to harass and intimidate Dr. Forman and Mr. Zaher. Meanwhile, the law firm was presumably billing Guardian at a rate of hundreds of dollars per hour. The deposition, lasting several hours, was pointless and did not deal with the facts of the case. Rather, it only served to increase legal fees to benefit Leader & Berkon and to create a chill on Dr. Forman and Mr. Zaher’s rights to free speech. Rather than stick to the issues such as healthcare fraud, Guardian’s outside counsel went on a fishing expedition, asking Mr. Zaher questions that were irrelevant to the case and outside the scope granted by the court.
Guardian had earlier attempted to dismiss Dr. Forman’s lawsuit but the New York State Supreme Court denied the motion. Guardian later appealed the decision, which was upheld by The N.Y.S. Supreme Court, Appellate Division, First Department, finding that the suit could proceed to trial on each and every count — a major blow to Guardian and its efforts to sweep Dr. Forman’s lawsuit under the rug and proceed with business as usual.
Dr. Forman, a 25-year veteran anesthesiologist and owner of a patent for healthcare fraud software, was engaged by Guardian over a six-year period to find overbilling and fraud on the part of doctors and hospitals, for which Dr. Forman would receive a fee of 25% of all recovered funds. Upon reviewing hundreds of thousands of claims provided by Guardian, Dr. Forman identified tens of millions of dollars in overbilling and fraudulently paid claims. He discovered that large hospital groups were, in many instances, triple billing or using incorrect codes on claims they submitted to Guardian for payment. Considering that his patented software is able to discover fraudulent billing for anesthesia, the case reveals just how rampant insurance fraud is, when you take into account other areas of medicine, amounting to tens of billions of dollars per year, according to health industry experts.
The lawsuit alleges that Guardian failed to pursue the unrecovered monies due to its having entered into separate contracts with Preferred Provider Organizations (PPOs). Despite entering into such agreements, Guardian asked Dr. Forman to perform audits of claims from providers that were part of the PPOs’ plans. Guardian’s contracts with the PPOs effectively precluded any possibility of recovery by Dr. Forman for nearly all of the claims that Guardian asked Dr. Forman to audit.
“This deposition was only to harass and intimidate myself and PRMG,” Dr. Forman said. “But it begs the question: What does Guardian have to hide? What is it about the case that Guardian doesn’t want its ratepayers or regulators to know about?”