In a major legal case, a Tennessee business owner named Michael Kestner was convicted for running a massive health care fraud scheme. Kestner, 72, of Nashville, owned and managed several pain clinics under the brand Pain MD, which operated across Tennessee, North Carolina, and Virginia. Over a span of eight years, Kestner defrauded the government by billing federal health care programs approximately $35 million for medical procedures that were completely unnecessary.
How Michael Kestner Carried Out the Fraud
Michael Kestner ran a chain of pain clinics where people came to get treatment, particularly those struggling with pain related to opioid dependence. Instead of providing the necessary care, Kestner pushed unnecessary medical procedures on these vulnerable patients. He forced his medical staff to administer injections that the patients didn’t need.
These injections, called Tendon Origin Insertion (TOI) injections, are supposed to help people suffering from tendon pain. But the problem was, most of the patients didn’t have any tendon pain. In many cases, it was impossible to perform the procedure correctly because the clinics didn’t even have the right equipment. Despite knowing this, Michael Kestner continued to instruct his staff to give these injections and then billed the government programs like Medicare for millions of dollars.
The situation was especially difficult for the patients. Many were dependent on opioid medication and were afraid of being denied treatment if they refused the injections. Some feared they would suffer withdrawal symptoms if they didn’t comply, making the pressure on them even more severe.
Michael Kestner’s Pressure on Medical Staff
Not only did Michael Kestner deceive the government, but he also created a stressful and unethical work environment for the medical professionals at his clinics. He frequently sent emails ranking his medical staff based on how many injections they gave. If they didn’t perform enough injections, they were criticized and made to feel like they could lose their jobs.
Dr. Fishberger Charged with Serious Health Care Fraud
This pressure forced doctors and nurses to give injections even when they knew it wasn’t necessary. Kestner ignored multiple warnings from insurance companies and even a lawsuit that told him his clinics were billing improperly. Despite these red flags, Michael Kestner pushed ahead with the scheme, making Pain MD the top biller for these types of injections in the entire country, billing eight times more than the next highest clinic.
Jury Convicts Michael Kestner
After a thorough investigation, Michael Kestner was found guilty by a federal jury on several charges. He was convicted of one count of conspiracy to commit health care fraud and 12 counts of health care fraud. This means the jury found that he knowingly and intentionally defrauded the government through his clinics and worked with others to carry out this massive fraud.
Kestner’s sentencing is scheduled for February 27, 2025, where he could face up to 10 years in prison for each count of fraud. This means he could spend a long time in prison for his role in the scheme.
The case was investigated by multiple government agencies, including the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Defense Criminal Investigative Service (DCIS), the Department of Veterans Affairs Office of Inspector General (VA-OIG), and the Tennessee Bureau of Investigation (TBI). These agencies work together to fight health care fraud and hold individuals accountable when they commit crimes against the government and patients.
In the end, Michael Kestner’s greed led him to commit serious crimes. His clinics, which were supposed to help patients in need of pain management and opioid treatment, became centers for fraud. Now, he faces the consequences of his actions.
