Allstate has filed three federal lawsuits against ASCs and their affiliated providers since mid-April, alleging schemes ranging from kickback arrangements and corporate practice violations to billing for procedures that were never performed.
1. Allstate sued Florida Orthopedics and Neurosurgery, which operates as University Orthopedic Care, alleging personal-injury protection fraud, according to court documents filed May 15 in the U.S. District Court for the Middle District of Florida.
The lawsuit alleges the Palm Springs, Fla.-based practice used a built-in kickback structure designed to multiply facility fees. When a patient was referred to an ASC, the practice allegedly billed Allstate a large facility fee, then sold the right to collect it to a related company for a fraction of the amount. In one cited instance, an ASC billed $16,500 for a radiofrequency ablation and sold the collection right to ASC Lender for $1,500. ASC Lender is partly owned by an individual with an ownership stake in a University Orthopedic ASC, according to the lawsuit.
2. Allstate is accusing a Chicago ASC of being 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 named more than a dozen defendants, 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 the ASC was “controlled and illegally operated by laypersons who lack medical licenses” in violation of Illinois’ corporate practice of medicine doctrine, which requires medical businesses to 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 contends she is not qualified to own a medical practice. The insurer also alleged defendants billed for anesthesia administered during injection procedures for chiropractic and physical therapy services that were not rendered or were misrepresented.
3. Allstate filed a federal lawsuit April 17 alleging Brentwood, Tenn.-based Surgery Partners and nine of its Florida subsidiaries conducted a coordinated scheme to defraud the payer of millions through false billing. The complaint, filed in the U.S. District Court for the Middle District of Florida, claims the scheme targeted patients in minor motor vehicle accidents and subjected them to “extraordinarily aggressive treatment” to inflate insurance claims beyond what injuries warranted.
Defendants include seven ASCs, Tampa Pain Relief Center and Anesthesiology Professional Services, all Surgery Partners subsidiaries. Allstate claims the defendants billed for procedures never performed, double- and triple-billed for components of single procedures, billed for more spinal levels than were treated and charged for supplies never used.
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