37
CODING
&
BILLING
Allstate, State Farm sue pain practices over alleged
billing schemes — 6 insights
By Angie Stewart
S
tate Farm and Allstate filed two sepa-
rate 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 e 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. e lawsuit makes several allegations,
including that Dr. Bothra billed Allstate for
facility fees and services performed at Inter-
ventional Pain Center's ASC three months
before the center actually opened.
3. Allstate claims both organizations per-
formed 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. e insurer is seeking
$3 million in damages. n
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