Eureka chiropractor sentenced to 20 months in prison, $2.3M restitution in health care fraud case

PEORIA — A chiropractor from Eureka has been sentenced to 20 months in prison and ordered to pay more than $2.3 million in restitution for defrauding Medicare and 12 insurance companies.

Following a 13-day federal jury trial in February, Carrie Musselman, 48, was found guilty of one count of health care fraud and five counts of wire fraud.

According to a news release from the U.S. Attorney's Office Central District of Illinois, Senior U.S. District Judge Michael M. Mihm sentenced her Tuesday.

During the sentencing hearing, federal prosecutors presented evidence that Musselman had engaged in a multi-year fraud scheme to steal more than $2.5 million from insurance companies.

According to the prosecutors' statement, Musselman submitted fraudulent insurance claims that led Musselman to receive automatic pay increases "to which she was not entitled."

“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, in the news release. “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 fraudulent claims included reporting services were performed by physicians when they were actually performed by mid-level providers; reporting patient services, like allergy injections, that were not provided; and misrepresenting services that were not provided — for example, placement of an electroacupuncture device, which was falsely billed as a surgically implanted neurostimulator.

For the claims for allergy injectors, the prosecutors said patients had instead been sent home "with oral drops that had not been approved by the Food and Drug Administration, were considered “experimental,” and had not been proven to be effective," according to the news release.

Mihm also found Musselman had committed perjury during her testimony, which made her statements lack credibility. He said she was well aware of the fraud she was committing, and she had directed and encouraged the fraud.

In the news release, Acting U.S. Attorney Gregory M. Gilmore said Musselman's case should serve as a warning to anyone who might commit health insurance fraud.

“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.”

Linda T. Hanley, special agent in charge with the U.S. Department of Health and Human Services' Office of Inspector General, said also said her agency remains committed to health care providers accountable in compliance with Medicare regulations, “so that enrollees can continue to rely on the program and receive the care they deserve.”

The case was investigated by the Department of Health and Human Services' offices of Inspector General and Investigations and the FBI Springfield field office. Assistant U.S. Attorneys Douglas F. McMeyer, Bryan D. Freres and Grace J. Hitzeman represented the government at trial.

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