Nashville Man Found Guilty in $35 Million Health Care Fraud Operation

Nashville Man Convicted in Massive Health Care Fraud Scheme

This week, right here in Nashville, a significant legal ruling sent shockwaves through the community as a local man found himself on the wrong side of the law. Michael Kestner, at the age of 72, has been convicted of a staggering $35 million fraud scheme targeting federal health care programs.

Details of the Case

The U.S. Department of Justice (DOJ) laid bare the shocking findings during the trial, which revealed Kestner’s involvement in an elaborate operation spanning nearly a decade. According to the DOJ, Kestner was not a medical doctor; however, he owned, operated, and managed multiple pain clinics branded as Pain MD across Tennessee, North Carolina, and Virginia. What his clinics allegedly did was nothing short of egregious: they billed federal health programs for medically unnecessary injections administered primarily to opioid-dependent patients.

The Mechanics of the Scheme

As the evidence unfolded during the trial, one thing became evident: Kestner exerted immense pressure on nurse practitioners and physician assistants within the Pain MD network. The testimony collected showed that these healthcare workers were compelled to administer multiple back injections to almost all patients seeking opioid treatment.

The pressure didn’t stop there. Patients who hesitated or declined to participate in this treatment were told in no uncertain terms that they risked being turned away from the clinic. This meant that those patients could potentially face withdrawal symptoms from their needed opioid medications. Talk about a tough spot!

Conviction Details

After hearing all the evidence, the jury reached a verdict that concluded Kestner’s wrongdoing. He was found guilty on one count of conspiracy to commit healthcare fraud and an astounding twelve counts of healthcare fraud. What does this mean for Kestner? He is scheduled to face sentencing on February 27, 2025, where he could be looking at up to 10 years in prison for each count if the judge sees fit to impose the maximum penalties.

The Broader Impact

This case has raised numerous eyebrows not just in Nashville, but across the entire country. The misuse of pain management clinics, especially those that cater to vulnerable communities like opioid-dependent individuals, is a serious issue. It sheds light on the desperate need for vigilance within our health care system.

The investigation that led to the downfall of Kestner wasn’t a solo act. It involved a collaborative effort among various federal partners, including the TBI Medicaid Fraud Control Division. Their hard work and dedication have led to a notable conviction that highlights how fraud in health care can severely affect patients who are already in a precarious position.

Looking Ahead

As the curtain draws on this shocking chapter, many local residents might be wondering what will come next regarding pain clinics and opioid treatment in their neighborhoods. Will this stir up change? Will it lead to stricter regulations in health care practices?

Only time will tell. But one thing is clear: the conviction of Michael Kestner serves as a chilling reminder of the need for accountability in health care. We hope this significant step sends a message to anyone considering exploiting those in need of medical attention.