Tennessee clinic owner convicted in $35M fraud scheme

 A Tennessee pain clinic owner was convicted of billing federal healthcare programs approximately $35 million for unnecessary medical injections.

Advertisement

Michael Kestner, who owned and operated Pain MD clinics in Tennessee, North Carolina and Virginia, administered unnecessary injections over nearly eight years to a population of opioid-dependent patients, according to an Oct. 25 news release from the Justice Department.

Mr. Kestner allegedly pressured nurse practitioners and physician assistants to perform multiple back injections on many patients who sought opioid treatment at Pain MD seeking opioid treatment. These injections were billed as tendon origin insertion injections, even though none of the patients were diagnosed with tendon pain. Additionally, it would have been medically impossible to administer these injections with the available equipment.

To maintain high billing levels, Mr. Kestner sent regular emails ranking practitioners’ performance, comparing them to each other. This created pressure among providers, who felt they might lose their jobs or let down their clinic staff if they did not increase the number of injections performed, according to the release.

According to the release, he also ignored repeated notices from insurance companies alerting that the clinics were improperly billing.

Advertisement

Next Up in ASC News

  • The federal physician self-referral law — better known as the Stark law — was enacted in 1989 and aims to…

  • Hospital consolidation continued in the past month, with health systems across the U.S. signing and closing merger, acquisition and transfer…

Advertisement

Comments are closed.