Maxim Healthcare Fraud Suit Settlement: CEO Has 'Regrets'
Maxim Healthcare Services Inc. Chief Executive Officer Brad Bennett said Monday his company regrets the circumstances which triggered a federal fraud lawsuit it settled on Monday.
The U.S. Justice Department on Monday announced a settlement of $150 million with the company, which avoided a possible trial for allegedly submitting more than $61 million in fraudulent billings to government health programs.
Maxim, one of the largest health providers in U.S. agreed to pay a criminal penalty of $20 million plus approximately $70 million to the federal government and approximately $60 million to 42 states – including more than $2.7 million to be paid to the state of New Jersey, the Department of Justice said in a statement.
"While we regret the circumstances that led to these agreements, the resulting enhancements have clearly made Maxim a better and stronger company. Most importantly, at Maxim there is now a renewed commitment to the highest standards of conduct and consistent delivery of high quality patient care," said Maxim CEO Brad Bennett in a statement.
To date, nine individuals involved in fraudulent practices – eight former Maxim employees, including three senior managers, and the parent of a former Maxim patient – have pleaded guilty to felony charges, the DOJ said.
Maxim said today it has reformed its core values and has terminated senior executives and other employees it identified as responsible for the misconduct.
“Companies scheming to profit by deceiving patients and defrauding taxpayer-funded government health care programs can expect close scrutiny and aggressive investigation,” said Tom ODonnell, Special Agent in Charge of the Health and Human Services Office of Inspector General (HHS OIG) region covering New Jersey.
“We will continue to carefully guard the nation’s vital health programs against those who put greed over patient care," ODonell added.
The criminal complaint accuses the Columbia, Md.-based Maxim of submitting more than $61 million in fraudulent billings to government health care programs for services not rendered or otherwise not reimbursable.
The investigation revealed that the submission of false bills was a common practice at Maxim from 2003 through 2009. During that time period, Maxim received more than $2 billion in reimbursements from government health care programs in 43 states, the DOJ detailed.
Maxim’s former officers and employees engaged in various conduct, including creating or modifying time sheets to support billings to government health care programs for services not rendered.
They also submitted billings through licensed offices for care actually supervised by offices without licenses and whose existence was concealed from authorities.
Additionally, they created or modified documentation, including documentation reflecting required training and qualifications of caregivers.
According to the terms of the settlement, Maxim has 24 months to meet all of its reform and compliance requirements.