September 12, 2011
Jefferson City, Mo. - Attorney General Chris Koster announced today that Missouri has reached a settlement with Maxim Healthcare Services, Inc. Maxim, a home health agency based in Baltimore, Maryland, provides in-home nursing and home health aide services to people with disabilities in 41 states. The settlement will return $2.4 million to the state’s Medicaid program.
Koster said the Settlement Agreement resolves allegations that Maxim offices in 41 states 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.
Koster said the investigation began with a whistleblower lawsuit filed in US District Court in New Jersey. The relator, who brought the suit on behalf of the government, is a New Jersey resident. The case began with allegations that a small number of false claims were filed on behalf of a single Medicaid recipient, but subsequently developed into a 41-state settlement.
“Medicaid pays companies like Maxim Healthcare Services to ensure Medicaid in-home nursing and home health aide services are delivered appropriately.” Koster said. “I am committed to holding companies responsible for doing what Medicaid pays them to do – make sure the services are provided properly and billed appropriately.”
The total civil settlement is $130 million, with $121.5 million 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.
Koster said citizens should report suspected Medicaid provider fraud or abuse and neglect to his Medicaid Fraud Hotline toll free at 800-286-3932, e-mail the complaint to firstname.lastname@example.org or complete a complaint form at the Attorney General’s Medicaid Fraud website at http://ago.mo.gov/divisions/medicaid-fraud-control-unit-faqs.htm.