Carol Ann Ryser, M.D., Barred from Practicing Medicine
Stephen Barrett, M.D.
Carol Ann Ryser, M.D.,who operates Health Centers of America (HCA) in Kansas City, Missouri, has surrendered her medical license and must shut down the clinic. These pledges were part of joint agreements under which she and her husband Michael pleaded guilty to fraud and tax evasion [1,2].
Ryser and the clinic have a long record of legal difficulty. The Missouri Courts case register indicates that since 1997, Ryser and/or HCA were listed as a defendant in more than 35 cases and that she and/or HCA had 16 judgments recorded against them . Eighteen of the suits were malpractice actions filed between August 2005 and April 2012. Two of the cases were filed by the Missouri Department of Revenue and 5 were filed by the Missouri Department of Employment Security. In December 2010, a Chicago Tribune report  stated:
- Eleven suits had been filed by patients who said Ryser had misdiagnosed them with Lyme disease.
- Court records showed that Ryser's malpractice insurers had paid over $2 million in settlements.
- The Missouri board had filed a complaint that accused Ryser of misdiagnosing patients with Lyme disease and overcharging them for unnecessary treatments.
- Ryser's attorney (Jacques Simon) said that Ryser denied the allegations in the suits and board complaint and had admitted no liability in the settlements.
- In 2009, FBI agents raided Ryser's office, home, and car and carted away 211 patients' charts, computer hard drives, and other files.
In June 2012, the Rysers were indicted by a federal grand jury for health care fraud and filing false tax returns. The indictment accused them fraudulently billing by "upcoding" and falsifying claims submitted to insurers in an effort to be paid more than the amount to which HCA was entitled. The scheme included: (a) billing for physician office visits when Carol was out of town or had little or no involvement with the patient, (b) billing for physician office visits when the patient contact was by telephone, (c) billing for services with no supporting documentation; (d) billing for physician-supervised intravenous services when no physician was on duty at the clinic, and (e) improperly billing for consultation services. The fraudulent billings,which totaled $359,168, yielded payments that totaled $51,789. The Rysers were also charged with filing false tax returns for the calendar years 2006, 2007, and 2008 .
The dollar amounts mentioned in the indictment are quite striking. The unsupervised treatments, which were intravenous infusions, averaged more than $11,000 per day for 29 days, a total of nearly $320,000. The average amount billed was about $738 per treatment. The Rysers reported gross income of $1,972,820 for 2006, $2,268,187 for 2007, and $3,317,203 for 2008, but the indictment states that their actual gross receipts were "materially greater."  The plea agreements indicate that the Rysers paid $615,749 less tax than they should have paid.
The HCA Web site states that the clinic is "dedicated to the diagnosis and treatment of chronic illnesses" and provides an "integrated approach" that combines traditional and alternative medicine . Although Carol Ann Ryser is board-certified in pediatrics, HCA's main focus appears to be on diagnosing and treating "chronic Lyme disease" with long-term antibiotics, an approach criticized by the Infectious Disease Society of America. The Web site provides little detail about her methods, but the malpractice complaints do provide information. The most recent complaint states that in 2006. Ryser (a) diagnosed Helen Bilsland with Lyme disease, hypercoagulation, lupus symptoms, beta strep, infections, and other disorders, (b) told Blisland that she had "bugs' living in her "biofilm," and (c) used inappropriate lab tests to persuade Blisland that she had diseases and health problems that she did not actually have .
The Missouri Board complaint accused Ryser of fraud and unprofessional conduct that included "willfully and continually doing inappropriate and unnecessary testing and incorrectly diagnosing Lyme disease . Her plea agreement bars her from ever practicing again or owning or working in any capacity for any health care provider. The agreements also include payment of $51,789 in restitution and recommended sentences of 24-30 months of imprisonment for Michael and 6 months of home detention followed by 30 months of probation for Carol.
- Plea agreement. United States of America v Carol Ann Ryser. U.S. District Court for the Western Distict of Missouri, Western Division. Case No. 12-CR-00189-DG, filed, March 26, 2013.
- Plea agreement. United States of America v Michael Earl Ryser. U.S. District Court for the Western Distict of Missouri, Western Division. Case No. 12-CR-00189-DG, filed, March 26, 2013.
- Suits and judgments against for Health Centers of America. Case.net Web site, April 2012.
- Callahan P, Tsouderos T. Chronic Lyme disease: A dubious diagnosis. Chicago Tribune, December 8, 2010.
- Medical clinic owners indicted for health care fraud, false tax returns. US Attorney news release, June 27, 2012.
- Indictment. United States of America v Carol Ann Ryser and Michael Earl Ryser. U.S. District Court for the Western District of Missouri, Western Division, filed June 26, 2102.
- HCA home page, accessed July 6, 2012.
- Petition for damages. Helen Bilsland and James Bilsland v. Carol Ann Ryser, M.D. and Health Centers of America. Circuit Court of Jackson County, Missouri at Independence, filed April 3, 2012.
- Complaint. State Board of Registration for the Healing Arts v. Carol A. Ryser, M.D. Before the the Administrative Hearing Commission, State of Missouri. Case No. 09-1693 HA, filed Dec 24, 2009.
This article was revised on March 30, 2013.