Going Rate for Bogus Pain Referrals?


Evidently it’s about $240 per patient.


I’m linking to a press release from the New Jersey Office of Insurance Fraud Prosecutor regarding a physician participating in a fraudulent conspiracy and money laundering scheme.


We have seen this story before. Evidently, five chiropractors received almost $200,000 for 790 patient referrals to a pain management clinic. As if the kickbacks weren’t bad enough, the pain doctor is then accused of submitting over $4.4 million in illegal bills for services to insurance companies.


The answer is the same if you want to do better:

  • Who is building your provider network?
  • Are you aggressively limiting your networks to the best physicians?
  • Is evidence-based utilization review part of your plan?
  • Is professional credentialing just an afterthought?


Call us. We can do better.

William Faris, JD
Chief Executive Officer

Posted in Bill's Favorite Files, OMCA