Texas spine surgeon sued by State Farm over 'unnecessary' procedures

Carly Behm -  

A San Antonio surgeon is being sued by an insurer over allegations he performed medically unnecessary spinal injections and procedures to inflate personal injury claims, according to a lawsuit filed July 26 in the Western District Court of Texas.

Five things to know:

1. Sanjay Misra, MD, allegedly filed multiple fraudulent patient evaluations for unnecessary surgeries to "exaggerate the severity and inflate the value of personal injury claims against State Farm Mutual and State Farm County," the lawsuit says.

2. State Farm has identified 335 patients who were treated by Dr. Misra. Of those patients, he recommended and/or performed spinal injections for 300 of them. 

3. The surgeries Dr. Misra recommended were usually microdiscectomies and anterior cervical discectomies and fusions. Nearly half of his patients were recommended for surgery, and some were recommended for both microdiscectomy and ACDF. He recommended surgery "even when there is no indication a surgery would provide any relief to the patient," the lawsuit alleges.

4. The lawsuit also alleges Dr. Misra purported to take patients' information, but evaluations were "boilerplate, include nonspecific information about the patients’ conditions and reveal noncredible patterns."

5. State Farm alleges it sustained damages of more than $1.1 million and is asking for a jury trial. Dr. Misra did not immediately respond to Becker's or the San Antonio Express News for comment.

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