Doctor Pleads Guilty to Making a False Statement to an FBI Agent and Signs Civil Agreement Requiring Payment of $830,329 to Government
|U.S. Attorney’s Office October 12, 2010|
ST. LOUIS, MO—Dr. Howard Goldstein pled guilty today to the federal felony charge of making a false statement to an agent of the Federal Bureau of Investigation. The charge stemmed from an April 2010 interview in which the defendant was questioned about problems with his Medicare billing practices and, in response to questioning, minimized and mischaracterized concerns and problems that had been raised by his former employer.
In his plea agreement, Dr. Goldstein admitted that between January and June of 2007, his former employer audited defendant’s Medicare claims, finding that the medical records created to document the services that Dr. Goldstein had billed to Medicare were scant and illegible, raising serious problems. Dr. Goldstein attended a meeting with his former employer where these issues were discussed in May 2007. His employer seriously considered terminating the defendant over these Medicare billing and documentation issues, but ultimately decided to allow him to remain employed while requiring attendance at a Medicare coding education session.
Later, during March 2009, another physician conducted routine peer review activities involving Dr. Goldstein. This peer review doctor discovered additional problems with Dr. Goldstein’s medical records and Medicare billing, and reported him to the former employer’s corporate compliance officer. Ultimately, Dr. Goldstein’s former employer contacted the government about these issues and the FBI began an investigation.
On April 20, 2010, special agents from the FBI and the Office of Inspector General for the U.S. Department of Health and Human Services (HHS-OIG) interviewed Dr. Goldstein in St. Louis, Missouri. During this interview, Dr. Goldstein made the false statement discussed above and tried to influence the investigation into his submission of claims for payment to the Medicare program.
Dr. Goldstein further agreed to pay $830,329 to the United States in a related civil settlement agreement and be excluded from participation in the Medicare program for a period of five years. In a separate civil settlement agreement, Dr. Goldstein’s former employer, SSM St. Charles Clinic Medical Group, Inc., and a related corporation, SSM Healthcare Corp., agreed to reimburse the United States an additional $865,812 for Dr. Goldstein’s false charges to Medicare, making a total civil recovery from the investigation of $1,696,141.
"Dr. Goldstein created a new problem for himself by not telling the truth," said Kenneth L. Moore, the Acting Special Agent in Charge of the FBI St. Louis Division. "Lying to the FBI is a felony and the consequences can be prison time and fines."
"The Office of Inspector General, Kansas City Regional Office will continue to work with its law enforcement partners and pursue providers who make false statements. We applaud the actions of Dr. Goldstein’s former employer for bringing these allegations forward," said Special Agent in Charge Les W. Hollie of the U.S. Department of Health and Human Services, Office of Inspector General.
DR. HOWARD GOLDSTEIN, formerly of Clayton, Missouri, now faces a maximum penalty of five years in prison and/or fines up to $250,000. Sentencing has been set for January 5, 2011. The plea agreement recommends the imposition of a fine of $30,000, which is the estimated maximum fine suggested by the Sentencing Guidelines, as well as requiring defendant to forfeit $100,000.
United States Attorney Richard G. Callahan commended the SSM St. Charles Clinic Medical Group, Inc. and SSM Healthcare Corp. for their diligence in discovering the billing irregularities and reporting them. "Just as with our tax system," he noted, "honest self-reporting by the industry is an important part of our enforcement efforts." Callahan also cited work performed on the case by the FBI, HHS-OIG and the Medicaid Fraud Control Unit of the Missouri Attorney General’s Office. He pledged that health care fraud would remain one of the office’s top priorities.