Health services firm to pay $150M in fines

Sept. 12, 2011 at 4:20 PM   |   Comments

WASHINGTON, Sept. 12 (UPI) -- A leading U.S. provider of home health services agreed to pay $150 million to settle a nationwide false billing scheme, the Justice Department said.

The agreement reached between the Justice Department and Maxim Healthcare Services Inc. resolves criminal and civil charges relating to a nationwide scheme to defraud Medicaid programs and the Veterans Affairs program of more than $61 million.

Under terms of the agreement, Maxim was charged with conspiracy to commit healthcare fraud and entered into a deferred prosecution agreement with the Justice Department, the department said in a release. The agreement allows Maxim to avoid a healthcare fraud conviction if it complies with the deferred prosecution agreement's requirements.

The agreement, which expires in two years if the company meets all of its reform and compliance requirements, requires Maxim to pay a criminal penalty of $20 million and to pay about $130 million in civil settlements, including to federal False Claims Act claims.

So far, nine individuals have pleaded guilty to felony charges arising from submitting fraudulent billings to government healthcare programs, creating fraudulent documentation associated with government program billings or lying to government healthcare program officials concerning Maxim's activities, the department said.

The criminal complaint accuses Maxim, a privately-held company with headquarters in Columbia, Md., of submitting more than $61 million in fraudulent billings to government healthcare programs for services not rendered or otherwise not reimbursable.

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