A group of Allstate Corp. insurance carriers has filed suit against a Texas pain management company and its affiliated clinics, accusing them of inflating medical bills tied to auto accident injury claims through unnecessary treatments and fraudulent billing practices, according to BestWire.
The complaint, filed in the U.S. District Court for the Northern District of Texas, names Foundation Physicians Group Inc. as the lead defendant.
Allstate claims the clinics billed more than $1.7 mn between 2019 and 2023 for “unreasonable and medically unnecessary” exams and injection procedures.
According to the lawsuit, personal injury attorneys allegedly funneled auto accident victims to the clinics, where legal offices – not doctors – dictated patient care.
Allstate said one of the physicians split fees with “laypersons and entities,” receiving a share of settlements routed through lawyers who paid the clinics.
Beginning in 2019, the clinics reportedly relied on a handful of part-time doctors while nurse practitioners handled most patient evaluations and decisions on procedures.
Allstate said that arrangement violated Texas law and left physicians effectively out of the loop. The lawsuit claims no doctors reviewed or approved injection procedures ordered by nurse practitioners.
In a separate state court case, employees testified that personal injury lawyers had to authorize every injection and diagnostic test.
Foundation, the filing notes, also failed to produce key medical records during that proceeding – including anesthesia notes, pre- and post-op reports, and fluoroscopic imaging. A Foundation physician later testified that the imaging files “were not retained.”
Allstate is invoking the Racketeer Influenced and Corrupt Organizations Act (RICO), seeking treble damages of $5.2 mn plus legal fees and court costs.
We think this case cuts straight into the murky intersection of medical billing and personal injury law – where legal referrals, clinical autonomy, and profit motives collide. If Allstate proves its claims, this could reset how carriers challenge coordinated billing networks across the state.
