Attorney General Gansler Secures $2.25 mil for Maryland in Medicaid Fraud Settlement
Maxim Healthcare Services agrees to pay $150 million to 41 states
MD ( Sept. 12, 2011) - Maryland Attorney General Douglas F. Gansler, along with 40 other state attorneys general and the U.S. Department of Justice, has reached a settlement with Maxim Healthcare Services, Inc. that will return $2,248,328 to the Maryland Medicaid program. Maxim Healthcare Services is based in Columbia, MD and provides in-home nursing and home health aide services to people with disabilities in 41 states.
“The $2.25 million we’ve recovered will help Maryland families who need the health care services this money provides,” said Attorney General Douglas F. Gansler. “This is an example of how Maryland can put such whistleblower cases to work in the future now that we have a False Claims law in place.”
Maxim agreed to pay a criminal penalty of $20 million along with approximately $130 million in civil settlements for submitting $61 million in fraudulent billings to government health care programs nationwide. The settlement agreement resolves allegations that Maxim submitted claims for services not rendered, and that the company submitted claims that lacked required documentation. The settlement also resolves allegations that certain Maxim facilities were not properly licensed and were therefore ineligible under the Medicaid rules to submit claims for reimbursement.
This investigation began with a whistleblower lawsuit filed in US District Court in New Jersey. The whistleblower or, “relator” who brought the suit on behalf of the government, is a New Jersey resident. This case began with allegations that a small number of false claims were filed on behalf of a single Medicaid recipient, and was subsequently developed by the government into a forty-one state settlement.
The settlement is the result of a joint investigation by the United States Attorney’s Office for the District of New Jersey, the US Department of Justice and a State Team of representatives from the Medicaid Fraud Control Units of New Jersey, Virginia, Massachusetts and Ohio. In addition to the civil settlement, Federal prosecutors have secured guilty pleas to criminal charges from 8 former Maxim employees, and the company has agreed to enter a deferred prosecution agreement. None of the 8 former Maxim employees who pled guilty are from Maryland.
Maxim has also agreed to the terms of a Corporate Integrity Agreement (CIA) with the Office of the Inspector General of United States Department of Health and Human Services (HHS-OIG), and will hire a corporate monitor, at company expense, to ensure compliance with the terms of the CIA.
The total civil settlement of $130 million includes $121,514,199.08 designated as Medicaid program recovery. (Medicaid is a state administered healthcare program for the indigent and disabled which is funded jointly by the states and the federal government.) The remaining portion of the civil recovery is for damages to the Veteran’s Administration program.