Two Kalispell chiropractors to pay $450,000 following Medicaid fraud settlement
HELENA – Two chiropractors in Kalispell have agreed to pay the State $450,000 for restitution to settle allegations of Medicaid fraud, Attorney General Austin Knudsen announced today.
The Montana Department of Justice’s Medicaid Fraud Control Unit (MFCU) received a referral from Blue Cross Blue Shield of Montana alleging 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 of Montana, from May of 2017 to December of 2021. During that time, Basler was the owner and president of Basler Family Chiropractic and Lund was an employee.
During an investigation into both doctors’ records from May 2017 through October 2021, MFCU identified claims that were non-reimbursable for reasons including that the referral was 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 a patient’s loss of function or impairment.
Under the terms of both agreements, Basler and Lund are not admitting to wrongdoing, however, both are repaying the money to Montana Medicaid. Basler agreed to pay a total of $300,000. The majority, $267,000, will reimburse the Montana Medicaid program and make it whole. The balance 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. The case was investigated by MFCU Agent Joe Neussendorfer.
Stevens Amendment Compliance Statement
The Montana Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $885,430.25 for Federal fiscal year (FY) 2024. The remaining 25 percent, totaling $295,143.42 for FY 2024, is funding by the State of Montana.