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Tuesday, 01/17/2012 10:23:13 PM

Tuesday, January 17, 2012 10:23:13 PM

Post# of 5091
SPIN's patients are sent to their affiliated clinics by chiropractors or PTs, who are essentially making the initial claim that the patient is, in fact, injured, and has not improved under their care. It is the evaluation of the chiropractor or PT that allows the case to reach a SPIN-affiliated pain clinic. These chiropractors are passing the patient along, although these patients may or may not have real/serious problems. Both the chiropractors and pain clinics are incentivized to continue to provide care to patients, regardless of their actual needs, due to their connection with the lawyers. If the chiropractors/doctors are willing to run up the bill that can be presented in a lawsuit, the lawyer stands to win more when the case is settled (as he is taking a percentage of the total bill). This is what SPIN management means when they say that the key relationships are with the lawyers. If the chiros/PTs are willing to keep the case alive, then the pain clinics can get involved and charge for their procedures as well. If the medical professionals are not providing large medical bills (which equate to large settlements), the ambulance-chasing lawyers will send their clients elsewhere.

So, point being, if a patient is forced to go to the ER as opposed to going directly to a chiro or pain clinic, the ER professionals might snuff out the case from the start and SPIN would never have the chance to get involved (and make money off of it, even if it was fraudulant). The golden question is; how much of the business that is referred to and/or carried out by the pain clinics actually fraudulant? (or represents bill padding). Since I am still long the stock, I am willing to bet not all of it. However, Florida is the number one state in the country for this type of fraud (due to their PIP insurance system), and I am not convinced that, in this environment, no fraudulent cases are slipping their way through under the current system. Rather, my concern was with the growth rate in Florida post-reforms, and the companies reliance on the Tampa hotbed of corruption. I would like to see the company expand into other states to mitigate some of this risk.

Below is a case demonstrating this type of fraudulent situation:

http://www.outpatientsurgery.net/news/2012/01/10-Insurer-Surgeons-Sue-Each-Other-Over-Back-Pain-Treatment

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