Joplin Physician Pleads Guilty to Health Care Fraud
SPRINGFIELD, Mo. – A Joplin, Mo., physician pleaded guilty in federal court today to providing false information in order to receive Medicare and Medicaid reimbursements to which she was not entitled.
Heather D. Stelling, 55, waived her right to a grand jury and pleaded guilty before U.S. Chief Magistrate Judge David P. Rush to a federal information that charges her with one count of making a false statement relating to health care.
Stelling was a pain management physician who owned and operated Stelling Pain Management, LLC, in Joplin. According to today’s plea agreement, Stelling continued to practice medicine from Sept. 12 to Sept. 24, 2018, despite believing that her medical license was suspended during that time.
Under state law, a Missouri licensed physician who fails to file or fails to pay any Missouri state tax for three years, shall have their license suspended. The Missouri Department of Revenue erroneously informed Missouri’s Board of Registration for the Healing Arts that Stelling had failed to file and/or pay state income taxes. Stelling was informed that, in order to avoid having her license suspended, she needed to obtain a certificate of tax compliance from the Department of Revenue by Sept. 12, 2018, which she failed to do. Stelling’s license to practice medicine was erroneously suspended on Sept. 12, 2018.
On Sept. 24, 2018, the Department of Revenue provided the Board of Registration for the Healing Arts with a certificate of tax compliance, Stelling’s license was reinstated, and her suspension was subsequently expunged.
Stelling knew that Medicare and Medicaid would not pay claims for services rendered to beneficiaries while her license was suspended. In order to receive payment, she billed Medicare and Medicaid for services rendered to beneficiaries while she believed her license was suspended by falsely claiming dates of service outside the period of her suspension. Stelling altered the dates of service in her patient’s records to conceal that the service had been rendered when she believed her license was suspended.
Stelling altered at least 24 of her patient records to make it appear as though she had not treated the patient during the time that she believed her medical license was suspended. Stelling billed Medicare and Medicaid for these services, knowing that the services were supported, in part, by false statements she had made in the patients’ records.
As a result of Stelling’s conduct, Medicare and MO HealthNet (Missouri’s Medicaid program) paid a total of $146,026 in claims they otherwise would not have paid. Under the terms of today’s plea agreement, Stelling must pay $127,750 in restitution to Medicare and $18,276 in restitution to MO HealthNet.
Under federal statutes, Stelling is subject to a sentence of up to five years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.
This Drug Enforcement Administration investigated this case with the Department of Health and Human Services, Office of Inspector General and the Missouri Attorney General’s Medicaid Fraud Control Unit.