S.A. doctor says insurance companies labeled him a criminal

His amended pleading comes more than eight months after the insurers sued him and his medical practice for allegedly performing unnecessary and expensive spinal surgeries and other procedures on patients injured in auto accidents to inflate the value of their insurance claims. He has denied the allegations in the suit filed in federal court in San Antonio.

In their causes of action, the insurers cite a federal law often associated with the prosecutions of mob bosses — the Racketeer Influenced and Corrupt Organizations Act, or RICO.

Submitting fraudulent bills through the US mail amounts to a “pattern of racketeering activity” meant to defraud the insurers, they alleged in their July complaint.

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The Texas Medical Board website shows Misra, who has been licensed for three decades, has no criminal history and no disciplinary actions against him.

The insurers are using their lawsuit to “squeeze” him — “a well-regarded doctor and expert witness” — “out of business to limit how much State Farm has and potentially will pay in the future to properly settle and litigate claims,” Misra says in his countersuit.

They are also trying to recover money from legal cases previously settled and/or litigated with 335 patients Misra treated for neck and/or back pain, he says. The companies say they paid more than $6.5 million to settle claims.

“State Farm is engaging in a concerted litigation strategy designed to harass, intimidate and dissuade physicians like (Misra) from treating automobile accident victims who assert claims against those insured by State Farm,” Misra’s countersuit says.

He recommended or performed spinal injections in the patients, with about half advised to undergo spinal surgery, the insurers allege. When the injections don’t resolve patients’ complaints, they say, the doctor recommends “expensive, medically unnecessary surgeries” that cost more than $50,000.

During a court hearing in the case last month, State Farm attorney Jared Heck told a judge what Misra allegedly said when a patient advised him that they didn’t want an injection.

The doctor “told them, ‘No shot, no money,’ ” Heck said during the hearing before US Magistrate Judge Henry Bemporad.

The statement drew an immediate objection from Ricardo Cedillo, a lawyer for Misra. Cedillo called the statement an “unsubstantiated allegation.”

“I look very much forward to confronting the person who said it, and I can tell you it’s going to be a show because I know I can discredit that person,” Cedillo said to the judge.

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In his countersuit, Misra said the insurers “improperly miscast” their “underlying medical liability claims as a RICO action.”

The insurers sued less than a week after they received an adverse verdict in a case decided by a Bexar County jury, he said. The plaintiff who prevailed was a patient Misra. The doctor also tested about the patient’s treatment. The plaintiff was among those identified in court exhibits that were part of the insurers’ complaint, he notes in his countersuit.

Misra’s claims against the insurers are for negligence and “tortious interference with prospective business relations.” In his original action, he also sued for defamation and business disparagement. He and his practice had suffered “a downturn of business opportunities” because of “State Farm’s smear campaign.” It couldn’t be determined why those claims were dropped.

Cedillo couldn’t reach Friday but previously declined to comment on the original countersuit after its filing last month.

The State Farm companies “look forward to making our case in court,” a spokesman has said.

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