One of the country's biggest home health care providers will pay $150 million in fines and settlements to resolve charges it billed for services never provided and falsified employee credentials in a nationwide scheme that entangled two Charleston-area workers, authorities said this week.
Maxim Healthcare Services, which has offices in Charleston, Columbia, Greenville and Greer, will repay nearly $1.4 million to the S.C. Medicaid program. That sum will be split between the state and federal governments, a spokesman for the state Attorney General said Tuesday.
The Columbia, Md., company was charged Monday in federal court in New Jersey with conspiracy to commit health care fraud but will avoid conviction if it complies with reform and compliance terms laid out by the U.S. Department of Justice, according to a release from the U.S. Attorney's Office in New Jersey.
The two local workers, who said they faced corporate pressure to increase their revenue despite level demand for their services, already have pleaded guilty to charges of making false statements relating to health care fraud, according to the release and court documents.
Gregory Munzel, 35, of Charleston was an account manager responsible for Maxim offices throughout the Southeast. He pleaded guilty in 2009 and is scheduled to be sentenced Sept. 29.
Marion Morton, 45, of North Charleston was a home health aide and personal care assistant who worked in Maxim's Charleston office. He pleaded guilty in 2010 and was sentenced in May to three years of probation and ordered to pay a $5,000 fine.
Munzel said his superiors at Maxim pressured him to increase the region's revenue. In response, employees he supervised submitted time cards for work they had not actually done. During his five-year employment at Maxim, which ended in 2005, Munzel said he forged caregivers' CPR cards and other credentials -- a practice he said he learned from supervisors when he first joined the company.
Morton, employed at Maxim from 2002 to 2009, said fellow employees told him to report on timecards more work than was physically possible. More than once, Maxim submitted bills to Medicaid based on timecards that showed a single employee worked more than 24 hours in one day.
"Fraudulent billing for services not rendered uses patients as pawns in a game of corporate greed that puts cash over care and wastes precious taxpayer dollars," Tony West, assistant attorney general for the U.S. Justice Department's Civil Division, said in a statement.
Maxim, which has hundreds of offices across the country, is accused of submitting more than $61 million in fraudulent claims from 2003 to 2009. It will pay about $130 million in civil settlements, including a $15.4 million payment to a whistleblower, and a $20 million criminal penalty.
Medicaid agencies in 42 states will receive payments, according to the U.S. District Attorney's Office in New Jersey.
The South Carolina Medicaid agency will receive about $416,000.
Nationally, eight former Maxim employees and one parent of a Maxim patient have pleaded guilty in the scheme.
"We take full responsibility for these events ... and we are pleased to reach a settlement that will allow us to move forward with the important work of caring for our patients and clients who depend on us each and every day," Brad Bennett, who became Maxim CEO in 2009, said in a statement.
The company will be overseen by a corporate monitor for the next two years.
The government's investigation is ongoing.