Dr. Padda Lawsuit: Medicare, Opioids, Tax, and Malpractice

The Dr. Padda lawsuit trail spans five distinct fronts: a nearly $6 million Medicare overpayment fight that reached the Eighth Circuit, opioid “pill mill” suits brought by Missouri counties, a U.S. Tax Court case over restaurant and brewery losses, real estate disputes tied to foreclosure and code violations, and a federal malpractice complaint. Dr. Gurpreet Padda, a St. Louis pain management physician who runs the Interventional Center for Pain Management and the Padda Institute, is a party in all of them.

The Medicare Recoupment Case

The largest suit began with an audit. CoventBridge Group, a contractor for the Centers for Medicare and Medicaid Services, reviewed claims from Padda’s pain practice and flagged an initial overpayment of $14,418.93. Using statistical extrapolation, auditors expanded that to roughly $5.96 million covering payments dating to 2016.¹

Padda challenged the demand through two rounds of administrative review. A qualified independent contractor sided with him in part, trimming the total to about $5.31 million plus interest. In May 2021, Medicare began withholding his reimbursements to recoup the money. Padda said he was receiving roughly $99,000 per month from Medicare, about a third of his practice’s revenue.²

In April 2021, he sued HHS Secretary Xavier Becerra in the U.S. District Court for the Eastern District of Missouri, seeking a preliminary injunction to halt the recoupment while an Administrative Law Judge weighed the merits. He argued the withholding violated procedural due process. The district court denied the injunction. On June 17, 2022, the Eighth Circuit affirmed, finding that two levels of administrative review had already given Padda a meaningful opportunity to be heard and that his claims of irreparable harm were “vague and speculative.” The panel noted he had not applied for an extended repayment plan.³⁴

An ALJ hearing was held on April 4, 2022, but no decision had been issued when the appellate court ruled. Padda later dropped the federal lawsuit. Whether he ultimately paid or settled the demand is not confirmed in publicly available records.⁵

Opioid “Pill Mill” Suits

In 2018, twenty-three Missouri cities and counties sued Padda along with dozens of other defendants, alleging their conduct fueled the opioid crisis. The suits named Padda personally, the Interventional Center for Pain Management, the Padda Institute, and Comprehensive Pain Associates, alongside major drug manufacturers, distributors, and pharmacies.⁶

The complaints labeled Padda’s practice a “pill mill.” They alleged that roughly half of his patients received oxycodone and nearly a quarter got OxyContin, and that the pharmacy inside his South City clinic ordered 6.9 million opioid dosage units between 2006 and 2014, the highest volume of any pharmacy in St. Louis city during that stretch. A Jefferson County complaint alleged patients drove in from outside the area after being turned away by doctors closer to home. The legal theories included public nuisance, negligence, fraud, and negligent misrepresentation.

Padda has been dismissed from some of the original suits but remains a defendant in cases brought by Jefferson and Franklin counties. As of mid-2026, no formal defense had been filed on his behalf in those cases, though a lawyer had entered an appearance. Jack Garvey, the attorney for the plaintiff governments, told St. Louis Magazine that Padda could face a default judgment, but that the municipalities were focused on larger defendants in the broader litigation.⁵

The Tax Court Case

Padda’s business ventures produced a separate fight with the IRS. In Gurpreet S. Padda & Pamela B. Kane v. Commissioner (T.C. Memo. 2020-154), the Tax Court considered whether he could deduct more than $3.2 million in losses from five restaurant partnerships and a brewery called Ninkasi, which operated as Cathedral Square Brewery.⁷ Padda held 50% interests in the restaurant partnerships and a 90% stake in the brewery. The IRS treated the ventures as passive activities because he worked primarily as a physician, which would have suspended the losses. The agency assessed deficiencies of $380,934 for 2010, $270,479 for 2011, and $424,963 for 2012, plus more than $300,000 in penalties.⁸

He won the core issue. After a day of testimony from Padda and twelve additional witnesses on his hands-on management, the court found he had spent more than 100 hours on each venture and more than 500 hours across all of them, meeting the significant participation test. The losses were nonpassive and deductible, wiping out most of the deficiency.⁹

The penalties were a mixed result. The court upheld a late-filing penalty for 2012, when the return was due October 15, 2013, but not accepted by the IRS until October 25. Reliance on the accounting firm was rejected as reasonable cause because of a history of late filings. A section 6662 accuracy-related penalty was sustained only for 2010, tied to an $81,828 constructive dividend the IRS found when Padda’s medical C corporation paid for his personal travel, meals, and event tickets.

Real Estate and Property Suits

Padda’s St. Louis real estate holdings have generated their own docket. Associated Bank, which held mortgages on his Padda Institute clinic building at Chippewa and Brannon and on several other properties, began foreclosure proceedings in February 2023 after he defaulted. A lawsuit accused him of “squatting” in the building for two years after losing ownership and sought roughly $1 million in attorneys’ fees and lost-rent damages.⁵

He also sued his insurer for $2.5 million over the former Second Baptist Church in the Central West End, which he bought in 2018 and which caught fire in October 2021. He said the insurer paid only $875,000. The building later sustained tornado damage and was left open and unsecured, drawing public criticism from the Central West End North Special Business District Commission.

The former St. Lucas Evangelical Church in Soulard, at Gravois and Allen, has drawn a separate suit. Built in 1866 and bought by Padda’s Soulard Property Group in 2010, the church suffered a 2023 fire that partially collapsed the roof. The city has condemned the building twice, and unpaid fines and code violations have accumulated. In September 2025, the Soulard Restoration Group filed suit to have the property declared a public nuisance and to transfer control to a third party. As of mid-2026, no hearing date had been set.¹⁰

The Malpractice Complaint

In Samuel Aye v. Gupreet Paada, et al., Case No. 4:22-cv-00562, filed in the Eastern District of Missouri, the plaintiff alleged that Padda committed medical malpractice and gross negligence by failing to recommend surgery for a spinal fracture diagnosed in 2017, which the plaintiff said led to permanent paralysis and nerve damage. Aye sought $20 billion in damages. In a June 2022 order, a magistrate judge found the complaint deficient on jurisdictional and pleading grounds and gave the plaintiff thirty days to amend or face dismissal without prejudice.¹¹ The available record does not show how the case was ultimately resolved.

What the Record Does Not Show

Padda has not faced federal criminal prosecution in connection with his prescribing. The research available for this article shows no DEA enforcement action and no state medical board disciplinary order against him. St. Louis Magazine reported that his prescribing is “almost certainly under a microscope” given the growth of state prescription drug monitoring programs, but that observation is not the same as a filed case.⁵

1
Becker’s ASC Review. Pain Physician Sues to Halt $5.9M Refund to Feds in Overpayment Case
2
United States Court of Appeals for the Eighth Circuit. Padda v. Becerra, No. 21-2823
3
FindLaw. Gurpreet S. Padda v. Xavier Becerra
4
Missouri Lawyers Media. Medicare Can Halt Payments to Overpaid Provider Awaiting Appellate Court Decision
5
St. Louis Magazine. Gurpreet Padda Real Estate St. Louis
6
St. Louis Business Journal. Missouri Counties Opioid Petition
7
Tax Notes. Doctor Materially Participated in Restaurants, Brewery
8
Forbes. Physician as Active Restaurateur and Literal Last-Minute Filing
9
Midpage. Gurpreet S. Padda & Pamela B. Kane v. Commissioner
10
St. Louis Magazine. Soulard Church Gurpreet Padda
11
GovInfo. Aye v. Paada, Case No. 4:22-cv-00562