What is the Dr. Emanuel Hoston insurance fraud case about and how significant is it?

Dr. Emanuel Hoston, an orthopedic surgeon and husband of Sonny Hosten, is at the center of a massive insurance fraud lawsuit involving nearly 200 healthcare providers. He's accused of providing fraudulent medical services in exchange for kickbacks by American Transit Insurance Company, which insures taxi, Uber, and Lyft drivers. This case represents one of the largest RICO cases ever filed in New York, with over 141 of the 186 defendants already agreeing to settle in principle. Dr. Hoston has denied the allegations, calling them a "frivolous smear campaign," but finds himself increasingly isolated as the vast majority of co-defendants have chosen to settle rather than fight the charges, highlighting the extensive nature of alleged healthcare fraud.