Fraudulent Billing Caught by Whistleblower

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Maxim Healthcare Services, a privately held company with 360 offices nationwide offering home health care services, has agreed to pay about $150 million to settle civil and criminal charges over claims of false billings to Medicaid and the Department of Veterans Affairs, the Department of Justice announced Monday.

Questions:

1. Since 2009, how many current and former employees of Maxim have pleaded guilty to related felony charges?

2. What types of schemes resulted in these false billings and what types of internal controls would have prevented this?

3. What is a whistleblower and how much will this person receive with respect to this case under the federal False Claims Act?

Source:

Wilson, Duff (2011). Maxim Healthcare Pays $150 Million in Fraud Case. The New York Times, September 12 (Retrievable online at http://prescriptions.blogs.nytimes.com/2011/09/12/maxim-healthcare-pays-150-million-in-fraud-case/)