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Multistate Settlement Reached In Medicaid Fraud Case

NEWARK, NJ (AP / WCBS 880) - A New Jersey man, Richard West, filed a whistleblower complaint against Maxim Healthcare Systems after figuring out he'd been overbilled.

WCBS 880's Levon Putney On The Story


It turns out that, according to Acting U.S. Attorney Gil Childers, the national home healthcare provider overbilled government programs in 43 states.

"One caregiver describes submitting phony time cards so that Maxim could bill a Medicaid program as if he was working more than 24 hours a day," says Assistant U.S. Attorney General Tony West. "Ultimately, each of us ends up footing the bill in higher health care costs."

Federal authorities in New Jersey have now announced a $150 million settlement against the Maryland-based health care company accused of defrauding Medicaid and other federal programs.

Maxim Healthcare Systems is a health care staffing agency based in Columbia, Md. It has offices in more than 40 states. A deferred prosecution agreement was announced Monday. Under it, Maxim will pay a criminal penalty of $20 million and civil penalties totaling about $130 million to Medicaid programs and the Veterans Affairs program.

Authorities had investigated the company for the past five years and charged it with conspiracy to commit health care fraud for submitting claims for services that were never provided and operating offices that weren't properly licensed.

The U.S. attorney's office in New Jersey and the state's attorney general joined authorities in 40 other states to reach the settlement.

(TM and Copyright 2011 CBS Radio Inc. and its relevant subsidiaries. CBS RADIO and EYE Logo TM and Copyright 2011 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)


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