SEATTLE (AP) A Seattle-area plastic surgery provider accused of threatening patients over negative reviews and posting fake positive ones must pay $5 million to the state attorney generals office and thousands of Washington patients, according to a federal consent decree.

The consent decree filed Monday resolves a lawsuit brought by Attorney General Bob Ferguson in December 2022, The Seattle Times reported . The complaint accused Allure Esthetic and owner Dr. Javad Sajan of violating state and federal consumer protection laws by posting the false reviews and forcing patients to sign nondisclosure agreements barring them from posting or saying anything negative about Allure.

The resolution, filed in U.S. District Court for the Western District of Washington, requires Allure to pay about $1.5 million in restitution to about 21,000 people. People who were forced to sign illegal NDAs will each receive $50, while those who paid a nonrefundable consultation fee before they signed an illegal NDA will receive $120.

The remainder of the money, about $3.5 million, will go to Fergusons office for attorney fees, litigation costs and monitoring and enforcing of the consent decree, according to the resolution.

Writing a truthful review about a business should not subject you to threats or intimidation, Ferguson said in a statement. Consumers rely on reviews when determining who to trust, especially services that affect their health and safety. This resolution holds Allure accountable for brazenly violating that trust and the law and ensures the clinic stops its harmful conduct.

Erin M. OLeary, an attorney for Allure Esthetic, said in a statement that the decision to settle was not easy but the company is pleased to have resolved the case.

The cooperative settlement, while not admitting fault and resolving claims asserted by both sides, allows Allure Esthetic to continue to focus on its core mission of providing compassionate care to patients, OLeary said.

Sajan, the owner of Allure, is based in Seattle. Allure also does business under several other names, including Alderwood Surgical Center, Gallery of Cosmetic Surgery, Seattle Plastic Surgery, Northwest Nasal Sinus Center and Northwest Face & Body, according to the lawsuit. The Alderwood Surgical Center and Northwest Nasal Sinus Center are also named in the consent decree.

The company provides surgical and nonsurgical services including plastic and cosmetic procedures, according to its website.

The complaint accused Allure of illegal business practices including artificially inflating its ratings on Yelp and Google by posting fake positive reviews and suppressing negative ones that were real.

According to the lawsuit, the company also rigged best doctor competitions hosted by local media outlets, kept tens of thousands of dollars in rebates intended for patients and altered before-and-after photos of procedures on patients.

Allure threatened to sue and did sue some patients if they did not take down negative reviews, according to the complaint. In some instances it offered patients cash and free services or products in exchange for taking down negative reviews. The practice also had more than 10,000 patients sign nondisclosure agreements before receiving treatment that restricted them from posting negative reviews online, the lawsuit said.

Sajan personally authorized the amount of money or value of services offered to patients who posted negative comments, the lawsuit said. He also allegedly directed employees to create fake email accounts to pose as patients and post positive reviews.

The resolution also requires Allure to hire a third-party forensic accounting firm to conduct an independent audit of its consumer rebate program to identify those who are owed rebates and, upon request, provide the attorney generals office with proof of compliance with the terms of the consent decree for the next 10 years.

If Allure or any of its related businesses violate the terms, they could face civil penalties up to $125,000 per violation.