The owner of a Kalispell chiropractic clinic and his employee have agreed to pay the state $450,000 in restitution to settle a Medicaid fraud case, Montana Attorney General Austin Knudsen announced today in a press release.
An investigation determined that Basler Family Chiropractic owner Cody C. Basler, 36, and Erik M. Lund, 30, submitted claims to the Montana Medicaid program for treatment that was not “medically necessary,” as defined by the state, from May 2017 to December 2021. The Montana Department of Justice’s Medicaid Fraud Control Unit (MFCU) received a referral from Blue Cross Blue Shield of Montana with the allegations.
During the investigation into their doctor’s records from May 2017 through October 2017, MFCU identified claims that were non-reimbursable, the release states. For example, Knudsen’s office says the chiropractors made referrals not directly related to a neuromuscular condition of the spine, the documentation reflected a reason for treatment was “general wellness,” and they lacked documentation of patient’s loss of function or impairment.
Under the terms of both agreements, Basler and Lund are not admitting to wrongdoing, the release states; however, both are repaying the money to Montana Medicaid. Basler agreed to pay a total of $300,000, most of which will be reimbursed to the Montana Medicaid program. The balance also represents additional civil penalties and damages.
Lund agreed to pay a total of $150,000, of which $87,000 will reimburse Montana Medicaid with the remainder representing civil penalties and damages.
Assistant Attorney General Bree Gee prosecuted the case and it was investigated by MFCU Agent Joe Neussendorfer.
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