R.I., others settle Medicaid fraud allegations for $150M

By PBN Staff

PROVIDENCE – Attorney General Peter F. Kilmartin said that a settlement with Maxim Healthcare Services Inc. will return $396,894 to the state’s Medicaid program.

The settlement resolves allegations that Maxim offices in 41 states submitted claims for services not rendered and that the company submitted claims that lacked required documentation, Kilmartin’s office said. It also resolves allegations that certain facilities were not properly licensed and therefore were ineligible to submit Medicaid claims for reimbursement.

Maxim was based in Baltimore and had an office at 148 West River St., Providence. It provided in-home nursing and home health aide services.

“This is a classic case of a company defrauding the government and wasting taxpayer dollars,” Kilmartin. “Medicaid is one of the state’s greatest costs, and as such we need to ensure every dollar paid to a Medicaid provider is being properly spent on patient care and not lining the pockets of corporations.”

The federal and multistate investigation began when a New Jersey resident filed suit in U.S. District Court with allegation that a small number of false claims were filed on behalf of a single Medicaid recipient and developed into the 41-state settlement.

The settlement was a $20 million criminal fine and $130 million to resolve civil allegations under the U.S. False Claims Act.

Additionally, federal prosecutors have secured guilty please to criminal charges from nine Maxim employees and the company has agreed to enter a deferred prosecution agreement.