The ROI of Questionable Medical Ethics

Medicare Set-Aside Blog on October 26, 2012
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Much like big pharma isn’t too upset when a drug goes bad and they have to pay out a few hundred million dollars in damages after a few billion in sales, apparently there is also return on investment for physicians deciding how badly to over-treat patients given the potential civil penalty doesn’t put a dent in years of ill-gotten gain. Many of you are aware that those of us in Maryland (and Joe Paduda) were very excited when the Maryland State Board of Physicians brought charges against one of our biggest pain mills earlier this year. Sadly, my excitement has wained considerably.

On October 4, 2012, Dr. Michael Franchetti signed a consent order agreeing to the following terms:

Three years probation

$25,000 civil fine payable to the Maryland Board of Physicians

To successfully complete:

A board approved one-on-one tutorial in medical ethics

A board approved course or one-on-one tutorial in medical record keeping

A one-on-one tutorial of “significant duration” in conservative orthopedic pain management

A board approved billing course that includes a comprehensive review and understanding of CPT coding

Three comprehensive scheduled peer reviews during the next three years where a minimum of ten patient charts will be reviewed


I have written hundreds of MSAs based upon medical records from this practice. This group of physicians routinely performed injective therapies regardless of efficacy, up-coded (say for instance a sciatic nerve blocks when only trigger point injections were performed or claimed multiple level or bilateral procedures when the facts didn’t line up), dispensed excessive quantities of drugs at extremely inflated prices from within their own offices (despite the many retail pharmacies within a mile of their various locations) on top of the ineffective injective therapies with little to no detail in the medical record other than prescriptions were renewed so as not to draw attention to the quantity and dose, and essentially bilked insurers in Maryland out of millions of dollars over at least the last decade if not longer. They put patients’ lives in danger. And this slap on the wrist fixes everything?

Please read this consent order to see exactly what the patients at this practice endured, then join the nation’s efforts to bring an end to our pain management crisis.

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