Pain Management Clinics aka Pill Mills

[AAP]

3) Doctors who just want to get paaaaaaiiiiiiid (said with my best Flava Flave accent). It's a good way to make money if you have the support services you need to provide ancillary services (i.e. X-ray).

Most don't have ancillary services. They require their patients to bring an xray with them or have it done somewhere else.

The article I read had the two brothers charging $80-$85 per office visit. And they made 14 million. (not to mention the 40 million they made "somehow" they were busted trying to launder). So how much could docs possibly make? Out of $85 per visit, even if they made $50 per patient they would need to see 40 patients a day just to make it worth their time.

 

[mrplunkey]

Most don't have ancillary services. They require their patients to bring an xray with them or have it done somewhere else.

The article I read had the two brothers charging $80-$85 per office visit. And they made 14 million. (not to mention the 40 million they made "somehow" they were busted trying to launder). So how much could docs possibly make? Out of $85 per visit, even if they made $50 per patient they would need to see 40 patients a day just to make it worth their time.

Naw, it's much easier than that. Simple x-ray machines (used) aren't that expensive at all. CT's and MRI's get expensive in a hurry, but a basic x-ray isn't that bad. Plus, they make a technical fee by taking the x-ray and a professional fee by reading it. That piles on top of the office visit.

They also get their own DME number and sell bracing (i.e. back/knee braces) along with other mid-range devices like hot/cold therapy units and walking boots. On a larger scale, they can lease space in their own office to a small pharmacy, and offer their own physical therapy services.

And remember too, they'll have an army of fitters, nurse practitioners and physicians' assistants seeing patients. With enough help, a doctor can easily see 10x the patients per day.

And here's the next big thing (it's happening now): About 40% of all US orthopedic implants are sold via specialty distribution. Some doctors are forming their own specialty distributor and selling implants to themselves. Of course they are their only customer, but they capture the specialty distribution fees.

 

[mrplunkey]

And the money they were trying to launder was probably from cash visits.

Picture this: You are uninsured and out of work. You can go to the pain clinic and pay a flat $300 (or so) visit fee on a cash-only basis. You walk away with a prescription for qty 90 of Oxycontin 80mgs. Even without insurance, you can buy generic at walgreens for $1160 with a discount card.

So selling them on the street for $1/mg, the patient just made 7,200 in income with an all-in cost of $1460.

Those $300 fees are probably what they are trying to launder.