Insurance provider Allstate is accusing an ASC in Chicago of being at the center of a scheme to fraudulently bill the payer for medically unnecessary procedures tied to auto injury claims.
In a federal lawsuit filed May 5, the insurer names more than a dozen defendants in the alleged scheme, including Roger Park One Day Surgery Center and its former owners, Narjisha Thowfeek and Mohamed Sirajudeen, chiropractor Manish Pandya and several affiliated providers.
The complaint alleges that the ASC has been “controlled and illegally operated by laypersons who lack medical licenses” in violation of Illinois’ corporate practice of medicine doctrine, which dictates that medical businesses must be owned by licensed clinicians.
Ms. Thowfeek, a licensed practical nurse, took over the practice in 2024 when it operated under the name Peterson Surgery. Allstate alleges that she is not qualified to own a medical practice.
Allstate further alleged that the defendants billed it for “improper and medically unnecessary surgery center fees,” for anesthesia administered during injection procedures for chiropractic and physical therapy services that, according to the complaint, were not rendered or represented.
Allstate is suing under the federal racketeering statute, Illinois fraud and unjust enrichment law. It is asking for triple damages, interest, costs and fees.
Becker’s has reached out to RPODSC and Allstate and will update this article if more information becomes available.
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