From the Office of Inspector General (OIG), U.S. Department of
Health & Human Services
Pain Management Clinics
Pain management clinics specialize in several methods of treating
chronic pain patients. This may involve therapy, injections, implantable
devices or oral pain medications. Most legitimate pain clinics have a
clinician who is trained or certified in the treatment of chronic pain.
However, now multiple fraudulent pain management clinics have sprung up
all across the country and in some areas have become a tremendous
How the Scam Works
Pain management clinics will recruit Medicare beneficiaries in a
nearby neighborhood and provide van transportation to clinics to treat
their “pain.” Once there, the beneficiary will typically
receive the following unwarranted and unnecessary services: a
consultation by a chiropractor, physical therapy, back adjustments by a
chiropractor, injections by a physician or physician assistant and
Sometimes these fraudulent pain clinics will bill for a traction
device called a Vax-D, which is not paid for under Medicare rules. In
addition, Medicare beneficiaries will receive trigger point injections
in their backs, but Medicare will get billed for a much more expensive
procedure called a facet injection. After all this fraudulent therapy,
the “patient” is taken by van again, treated to lunch and
driven home. The whole process begins again in a few days, and the
fraudulent billing continues.
How to Fight Back
Be careful in accepting medical services that are proactively
offered by a health care professional you do not know.
If someone comes to your door and says he is from Medicare or some
other health care company simply shut the door.
Be suspicious if you are told that Medicare wants you to have this
item or service and claim that, “We know how to get Medicare to
pay for it.”