TN pain clinic: forcing patients to receive unnecessary injections into their back, then intentionally mislabeling the injections during billing

Four Tennessee pain clinics closing after arrests, fraud allegations

https://www.tennessean.com/story/news/health/2019/05/09/tennessee-pain-clinics-closing-painmd-rinova-fraud-allegations/1153043001/

Four Tennessee pain clinics have abruptly closed in the wake of federal authorities accusing executives and employees of inflating profits by giving patients thousands of worthless injections.

The clinics were formerly part of PainMD but were re-branded under the name Rinova after PainMD was accused of widespread fraud. The shuttered Rinova clinics are in Clarksville, Cookeville, Lawrenceburg and Tullahoma.

The clinics officially closed at the end of business on Wednesday. Some employees found out that same day the clinics were shutting down and they were losing their jobs. When contacted on Thursday morning, an employee said at least one clinic was minutes away from locking its doors for good.

Rinova is owned by Dr. Benjamin Johnson, a former PainMD executive who bought the four clinics in February when PainMD was quietly carved into thirds and sold off to company insiders. Johnson could not be reached for comment.

The abrupt closure of these clinics comes after months of escalating allegations against PainMD, which is headquartered in Franklin and at one point owned or managed as many as 30 pain clinics in Tennessee, North Carolina and Virginia. Both state and federal authorities have sued Pain MD alleging it committed health care fraud with bogus injections, and three PainMD nurse practitioners were criminally indicted for this same scheme last month. All three suspects have pleaded not guilty.

INVESTIGATION: Pain clinics, needles and greed: PainMD accused of injecting patients to meet profit quotas

It also appears that criminal investigation is climbing the company ladder. In the recent indictment, federal prosecutors also cast fraud allegations against the PainMD owner and chief medical officer, who are identified in court records by their job titles only. A separate, civil lawsuit related to the case identifies the owner of PainMD as Michael Kestner and the chief medical officer as Dr. Lisabeth Williams.

Over the past two weeks, the company has filed numerous court records under seal in an effort to hide the names of its leadership, arguing they would face “intense media scrutiny” and “damage to (their) personal and professional reputations” if they were identified as suspects in a criminal investigation.

Kestner and Williams have not been charged with any crime. U.S. Attorney Don Cochran has declined to say if they will face charges, but stressed that federal prosecutors have many ongoing investigations into medical practitioners.

PainMD’s attorney, Jay Bowen, did not immediately respond to a request for comment on Thursday.

The alleged PainMD scheme hinges on two pain-relieving injections that sound similar but are dramatically different when it comes to government reimbursement. The lawsuits say that PainMD staff gave patients “trigger point injections,” which government insurance programs will generally cover about four times a year, but intentionally mislabeled these injections as “tendon origin injections,” a more expensive procedure for which coverage is not capped. The result of the scheme, as alleged in court records, is that PainMD got rich, taxpayers got screwed and patients got jabbed with a needle over and over for no justifiable reason at all.

PAIN CLINICS: Feds to sue Sen. Steve Dickerson and other pain clinic owners over fraud, forgery allegations

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.

One Response

  1. This fraud scheme has been used for over a decade. People denied pain care are forced to undergo these painful, expensive and sometimes dangerous injections. Of course the outcomes are not tracked and the occasional death or paralysis victim, can be explained away. CMS is most certainly not tracking the costs, outcomes or adverse incident reports. Death, infection and paralysis are more acceptable than the perceived horrors of opioid addiction.

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