Attorney General Sam Olens announced today that
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.
This investigation began with a whistleblower lawsuit filed in U.S. District Court in
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 Medicaid Fraud Control Units. In addition to the civil settlement, the company has agreed to enter a deferred prosecution agreement. Maxim has also agreed to the terms of a Corporate Integrity Agreement (CIA) with the Office of the Inspector General of 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.
The total civil settlement is $130 million, with $121,514,199.08 designated as Medicaid program recovery. The remaining portion of the civil recovery is for damages to the Veteran’s Administration program.