PEORIA, Ill. – A Eureka chiropractor, 48-year-old Carrie Musselman, was sentenced on Tuesday to 20 months in prison and ordered to pay more than $2.3 million in restitution for scheming to defraud Medicare and twelve other insurance companies.
A jury found Musselman guilty of one count of healthcare fraud and five counts of wire fraud after a 13-day trial in February.
At the sentencing hearing, the government presented evidence that Musselman engaged in a multi-year fraud to steal more than $2.5 million from Medicare and other insurance companies.
As part of the scheme, Musselman submitted fraudulent insurance claims indicating that services had been performed by medical doctors, when they were actually performed by mid-level providers. That resulted in automatic pay increases for Musselman that she was not entitled to.
Musselman also made false claims asserting patients had received services not provided. These claims included documentation that said some patients were provided allergy injections that were never given to them. Instead, patients were sent home with oral drops that had not been approved by the FDA, were considered “experimental,” and had not been proven to be effective.
Court records also show that Musselman also misrepresented services that were provided, resulting in her receiving payments she was not entitled to receive. One of Musselman’s most highly reimbursed services, the placement of an electroacupuncture device, which she falsely billed as a surgically implanted neurostimulator, would not have qualified for any payment.
At the hearing, Senior U.S. District Judge Michael Mihm found that had committed perjury in her testimony. In doing so, the judge noted that Musselman’s statements lacked credibility. He said that Musselman was well aware of the fraud she was committing and that she had directed and encouraged the fraud.
“This case should serve as a warning to anyone who would commit fraud against health insurance,” said Acting United States Attorney Gregory M. Gilmore. “We will seek out fraud, waste, and abuse and prosecute those who engage in it. Providers who take advantage of the trust placed in them to line their own pockets abandon their ethical responsibilities and raise health insurance costs for vulnerable patients.”
“The submission of false claims undermines the integrity of our federal healthcare system,” said Linda T. Hanley, Special Agent in Charge with the United States Department of Health and Human Services Office of Inspector General. “We remain committed to holding healthcare providers accountable for complying with Medicare regulations so that enrollees can continue to rely on the program and receive the care they deserve.”
“Bad actors in healthcare, such as Dr. Musselman, think they can cover up fraud through clouded paperwork and technical healthcare jargon all while they commit illegal acts such as false claims, fraudulent services, and in this case, services not even rendered,” said Christopher J.S. Johnson, the Special Agent in Charge of the FBI Springfield Field Office. “This sentencing and ordered restitution are a testament to the FBI’s commitment to working these types of cases. It doesn’t matter how clouded the paperwork, or how many files there are to go through, if there is a victim, then there will be an agent investigating it.”
The case was investigated by the Department of Health and Human Services, Office of Inspector General, Office of Investigations, and the Federal Bureau of Investigation, Springfield Field Office.
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