(COLUMBUS, Ohio)—Ohio Attorney General Mike DeWine announced today that Ohio 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. Ohio’s federal and state share of the settlement is approximately $14,823,000, with $6,054,000 representing the state portion retained.
“When there is fraud and abuse in the Medicaid program our office is dedicated to taking the necessary civil and criminal action to recover the public's money,” said Ohio Attorney General Mike DeWine.
The 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.
The settlement is the result of a joint investigation by the U.S. Attorney’s Office for the District of New Jersey, the U.S. Department of Justice, and a state team of representatives from the Medicaid Fraud Control Units of New Jersey, Ohio, Virginia and Massachusetts. In addition to the civil settlement, federal prosecutors have secured guilty pleas from or criminal charges against nine Maxim employees, and the company has agreed to enter a deferred prosecution agreement.
The total civil settlement is $130 million, with $121,514,000 designated as Medicaid program recovery. Medicaid is a state administered healthcare program for low income and disabled people which is funded jointly by the states and the federal government. The remaining portion of the civil recovery is for damages to the Veterans Administration program.
This investigation began with a whistleblower lawsuit filed in U.S. 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 and was subsequently developed by the government into a 41 state settlement.
Maxim has also agreed to the terms of a Corporate Integrity Agreement (CIA) with the Office of the Inspector General of the U.S. Department of Health and Human Services and will hire a corporate monitor, at company expense, to ensure compliance with the terms of the CIA.
Lisa Hackley: 614-466-3840
Mark Moretti: 614-466-3840