$35 million fraud scheme; gambling is a public health threat; childhood BMI can predict impaired lung function – Morning Medical Update

Author(s):

Austin Littrell

Key Takeaways

Michael Kestner fraudulently billed $35 million for unnecessary injections at Pain MD clinics, exploiting federal health care programs.
Kestner, unlicensed, pressured staff to administer injections, making Pain MD the top Medicare biller for TIO procedures.
Gambling is recognized as a global public health threat, with calls for government regulation and support.
Abnormal BMI in children is linked to impaired lung function in adulthood, but normalization before puberty can prevent this.

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$35 million fraud scheme

Michael Kestner, 72, of Nashville, Tennessee, was convicted for fraudulently billing federal health care programs for approximately $35 million, over the course of eight years, for medically unnecessary injections. The injections were administered to opioid-dependent patients at Kestner’s Pain MD clinics in Tennessee, North Carolina and Virginia.

Kestner, who is not a licensed physician, owned, operated, and managed the Pain MD clinics, pressuring nurse practitioners and physician assistants to provide multiple back injections to patients seeking opioid treatment, and patients who refused regular injections risked being turned away. The injections were billed as Tendon Origin Insertion injections (TOIs), making Pain MD Medicare’s highest biller of TIO procedures in the country. The jury convicted Kestner of one count of conspiracy to commit health care fraud, and 12 counts of health care fraud. He faces a maximum of 10 years in prison for each count.

Gambling is a public health threat

The Lancet Public Health Commission on gambling estimates that 46.2% of adults and 17.9% of adolescents have engaged in gambling over the past year, globally. Gambling has implications that stretch far beyond a simple leisure activity, affecting an individual’s health and wellbeing, wealth, and relationships, among other things. The Commission calls for governments to address gambling as a public health concern, with plans for regulation, protections and support.

Abnormal BMI in children can predict impaired lung function

Irregular BMI in children, abnormally high or low, can be associated with impaired lung function in adulthood, according to researchers from Karolinska Institutet in Solna, Sweden. The impairment can, however, be offset if the child’s BMI is normalized before they reach adulthood. “Interestingly, we found that in the group with an initially high BMI but a normalized BMI before puberty, lung function was not impaired in adulthood,” Erik Melén, principal investigator and professor of pediatrics at Karolinka Institutet. “This highlights how important it is to optimize children’s growth both early in life and during their early school years and adolescence.”