St. Louis-Area Internist, Employer to Pay $1.6M to Settle Medicare Fraud Case

A former St. Louis-area internist has pleaded guilty to making false statements to the FBI about his billing practices and has agreed to pay part of a $1.6 million settlement, according to a St. Louis Post-Dispatch news report.

Howard Goldstein, MD, was first suspected of questionable billing practices by his former employer SSM St. Charles (Mo.) Clinic Medical Group, who first audited his Medicare claims in 2007 and reported the documentation was "scant and illegible," according to the report.

Rather than firing him, SSM enrolled him in a Medicare coding education session. However, another physician carrying out routine peer reviews in 2009 found Dr. Goldstein's medical records and Medicare claims were questionable again and reported him to the corporate compliance officer. SSM proceeded to contact the authorities, according to the report.

When questioned about the false charges made to the Medicare program by FBI agents and the Department of Health & Human Services Office of Inspector General, Dr. Goldstein reportedly "minimized and mischaracterized concerns and problems that had been raised by his former employer." He later pled guilty to making false statements, according to the report.

In conjunction with his guilty plea, Dr. Goldstein has agreed to pay more than $830,000. SSM will also pay more than $865,000, according to the report.

Read the St. Louis Post-Dispatch news report about Dr. Howard Goldstein's guilty plea and settlement.

Read other coverage about physician fraud:

- Arizona Physician to Pay $395K to Settle False Claims Allegations

- Illinois Pediatrician Gets 3 Years Probation for Falsely Billing Health Insurance Companies for Free Vaccines Provided by CDC

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