Pain clinic owner Michael Kestner’s injections proved to be part of a decade-long fraud scheme that made millions

Pain MD was once among the nation’s most prolific users of “tendon origin injections,” which normally inject a single dose of steroids to relieve stiff or painful joints.

As many doctors were scaling back their use of prescription painkillers due to the opioid crisis, Pain MD paired opioids with monthly injections.

Four Pain MD employees have pleaded guilty or been convicted of health care fraud, including company president Michael Kestner .

Pain MD billed BlueCross BlueShield of Tennessee about $40 million for 380,000 injections from 2010 to 2013 .

Tens of thousands of additional injections were billed to Medicaid and Tricare , court documents say.

Ex- U.S. attorney Don Cochran said the Pain MD case felt especially “nefarious” because it used opioids to make patients play along.

Eight former Pain MD medical providers testified that the driving force behind Pain MD’s injections was Kestner , not a medical professional.

One nurse practitioner testified that she received emails “every single workday” pushing for more injections.

Another nurse practitioner said he “performed so many injections’ that his hand became chronically inflamed and required surgery.