Allstate, State Farm sue pain practices over alleged billing schemes — 6 insights

State Farm and Allstate filed two separate lawsuits accusing physicians and their pain practices of illegal billing schemes, Claims Journal reports.

Six insights:

1. Allstate filed a lawsuit April 22 seeking $860,000 in damages from The Pain Center USA and Interventional Pain Center, as well as Rajendra Bothra, MD, and Eric Backos, MD, who reportedly operated the Warren, Mich.-based clinics.

2. The lawsuit makes several allegations, including that Dr. Bothra billed Allstate for facility fees and services performed at Interventional Pain Center's ASC three months before the center actually opened.

3. Allstate claims both organizations performed interventional treatment for patients without having them undergo a regimen of conservative care, and staggered the dates of procedures commonly performed the same day to maximize charges.

4. Separately, State Farm is suing Nooruddin S. Punjwani, MD, and Baytown, Texas-based Pain Alleviation & Interventional Needs, the clinic where he practiced.

5. State Farm accused Dr. Punjwana of performing epidural steroid injections for nearly all of his patients without performing sound medical examinations to determine whether the injections were necessary. Dr. Punjwana also allegedly billed the insurer for conditions that didn't exist or exaggerating severity.

6. State Farm's lawsuit accuses clinic's owners — Barketal Roopani and his sons Anil and Sohail Roopani — of benefiting from the alleged fraud scheme. The insurer is seeking $3 million in damages.

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