Flushing-area chiropractor accused of $48,000 insurance scam involving teacher massages

Published: 2009-08-19 13:11:57
Author: Bryn Mickle | The Flint Journal | July 26, 2009

MT. MORRIS TOWNSHIP, Michigan -- Massages for Flushing teachers were supposed to decrease under their new union contract three years ago.

Instead, authorities say a local chiropractor who told the teachers to keep coming used them as unwitting participants in an alleged $48,000 insurance scam.

Miguel M. Ruelan, 39, is accused of defrauding Blue Cross Blue Shield by giving massages to teachers and other patients whose insurance didn't cover the service then billing the insurance giant for medical procedures that were never performed.

Authorities say the fraudulent massage bills began in December 2007 after the Flushing School District stopped getting teacher health care through the Michigan Education Special Services Association, or MESSA, a third-party administrator affiliated with the Michigan Education Association.

After the district switched to a lower cost Blue Cross plan, Ruelan allegedly sent Flushing teachers a letter telling them their massages would continue to be covered by insurance at his office despite a change in the teachers' insurance plan that cut the number of allowed visits from 38 to 24 a year.

Apparently suspicious about the number of teachers being treated at Ruelan's Pierson Road office, Blue Cross sent in undercover investigators to get massages that weren't covered on their insurance cards. Those massages were allegedlly billed to Blue Cross as "mechanical traction" treatments, said Genesee County Sheriff Robert J. Pickell, whose department opened a criminal probe in February.

Mechanical traction typically involves pulleys or motorized units to treat spinal conditions.

But Pickell said what was given was a traditional hands-on massage by a massage therapist in the office.

The bills ranged from $160 to more than $200 per session.

In all, investigators believe Ruelan submitted more than $48,000 in fraudulent bills to Blue Cross from December 2007 to November 2008.

There is no indication that teachers knew about the alleged billing fraud, officials said.

"The teachers were totally unaware of what was going on," said Pickell, adding it was unknown how many teachers got massages.

The Journal could not reach Ruelan's attorney, Leo P. Carey, for comment. The Journal also tried to contact Blue Cross and a Flushing teachers' union representative for comment.

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