HCA Healthcare
March 15, 2019

SOURCE: Nashville Tennessean

AUTHOR: Brett Kelman

A Nashville-area doctor who founded one of the largest pain management companies in the nation has been accused by federal prosecutors of profiting from a conflict of interest involving mandatory psychiatric evaluations for some chronic pain patients.

Dr. Peter Kroll was CEO of Comprehensive Pain Specialists when the company collapsed last year. Kroll now works for another pain clinic company at TriStar Hendersonville Medical Center.

Dr. Peter Kroll is a founder of massive pain clinic chain Comprehensive Pain Specialists who has been accused by federal prosecutors of profiting from a conflict of interest on psychiatric evaluations. (Photo: Tennessean file photos)

Prosecutors say Kroll had a conflict of interest when prescribing implanted pain pumps, a small device that is surgically placed under the patients skin to inject medication directly into their spinal cord. Patients are generally required to pass a psychiatric evaluation to verify they can handle the responsibility of a pain pump before the device is implanted.

Prosecutors say that Kroll sent his patients to be evaluated at a Ascend Medical Group, a Nashville company where he also worked as medical director.

Kroll would "then drive across town, switch hats, and employ and supervise the person who performed the psychiatric evaluation despite a clear financial motive to ensure that each patient was 'cleared' to receive a pump," court records state.

Kroll has not been criminally charged.

Allegations against him surfaced in federal court records filed this week in the prosecution of John Davis, his predecessor as CEO of Comprehensive Pain Specialists, who has been accused of accepting bribes.

Court records do not name Kroll specifically – he is identified only as "Dr. P.K. of CPS" – but a doctor list on CPS's website show Kroll is the only medical professional in the company with those initials.

Kroll did not respond to requests for comment left at his work or home.

Pain clinics left patients without prescriptions, records

The new allegations against Kroll are yet another scandal around Comprehensive Pain Specialists, a once-massive company that shut down last summer with little warning for employees and patients. The company, headquartered in Brentwood, was founded in 2005 by four doctors, including Kroll and Sen. Steve Dickerson, R-Nashville, an anesthesiologist. CPS treated tens of thousands of patients across 40 clinics in 12 states, growing to the largest pain management company in the American Southeast.

The Comprehensive Pain Specialists clinic in Murfreesboro is among those that have closed abruptly. (Photo: Helen Comer / DNJ)

Most of those clinics closed on July 31, 2018, after giving patients only weeks or days of notice. Countless patients with chronic pain were left to search for a new doctor, many in states that had become increasingly suspicious of new opioid prescriptions. For some, that search was complicated because CPS failed to release their medical records, making it nearly impossible for them to get a new prescription from another clinic.

CPS was further marred by the indictment of Davis, who led the company as CEO from 2011 to 2017. Prosecutors have alleged that Davis accepted bribes in return for medical referrals and plotted to forge the signature of a dead patient so conspirators could continue to bill Medicare in his name.

New allegations against former CEO

The court records filed this week also levy new allegations against Davis, accusing him of profiteering with Kroll even before he became CEO.

Records say that, prior to being hired at CPS, Davis worked as a sales representative who sold pain pumps for Medtronics, the largest medical device company in the world. Knowing that psychiatric evaluations were required for pain pump patients, Davis founded Ascend and hired Kroll as medical director. As alleged, the arrangement made it so Davis and Kroll profited form both the prescription of pain pumps and the evaluations that were designed to insure the pumps were used safely.

"To make matters worse, rather than hire a licensed psychiatrist, (Davis and Kroll) employed a nurse practitioner to do psychiatric evaluations," court records state.

Prosecutors plan to call that nurse practitioner as a witness at Davis' trial later this month.

Kroll currently works for Therapix Medical Solutions, a pain management company that purchased several CPS clinics after the company closed, including a clinic at the TriStar hospital in Hendersonville.

David Bolling, a spokesman for the U.S. Attorney's Office, declined to say if Kroll was the subject of a criminal investigation.

Dickerson, who was employed by CPS until it shut down, has never commented publicly on the allegations against the company. He did not respond to requests for comment.

Kaiser Health News contributed to this report.