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Doctor-shopping could be affecting concussion settlement

Football Brain Disease

This combination of PET scans provided by UCLA on April 2, 2015 shows, from left, a normal brain scan, a suspected Chronic Traumatic Encephalopathy (CTE) subject, and a subject with Alzheimer’s disease. In a report released on Monday, April 6, 2015, researchers say this brain-scanning technique might one day help doctors identify people with CTE, a disease linked to concussions in football and other sports, an illness now diagnosed after death. Symptoms include memory loss, confusion, aggression, depression and progressive dementia. These images are from the article “In vivo Characterization of Chronic Traumatic Encephalopathy (CTE) using [F-18]FDDNP-PET Brain Imaging,” first author Jorge R. Barrio. (AP Photo/PNAS/David Geffen School of Medicine at UCLA)

AP

As the NFL’s payout in the concussion settlement approaches $500 million, nearly 10 percent of that amount may have been paid based on recommendations from doctors who are a little too loose with the medical findings that support compensation.

Via the Associated Press, the NFL has requested the adoption of a 150-mile limit to the distance from a player’s home to the location of his doctor, in order to prevent doctor-shopping and fraud.

“We didn’t notice it until the claims were coming in,” fund administrator Orran Brown said in court regarding four doctors who were dismissed from the program due to “high-volume” player traffic and questionable findings. "$46 million went out the door on these claims before we could flag it.”

The presiding judge seemed to agree that some sort of limit is justified.

“A few were brought to my attention where we had a lawyer from Pennsylvania and a player from Florida going to a doctor in Texas, and that was a red flag,” Judge Anita Brody said.

The NFL expects to pay out $1 billion over 65 years. Brown said in court that $485 million has been paid, and that another $174 million in claims have been approved. The NFL has appealed 30 percent of all claims, but HALF of those were approved by the four doctors who have now been excluded from the case.