Photo: marshalastor via flickr
Richard West was shocked when he went for some dental work and found his Medicaid benefits had maxed out.Pulling up his Medicaid record, he totaled the care he’d received, the bills submitted by his provider — and found the problem.
According to The Star-Ledger, West, 63, found the company arranging his nursing care, Maxim Healthcare, was over-billing the government for hundreds of hours of service from people he’d never seen.
After calling several government hot-lines and receiving no help, he got a lawyer of his own.
That phone call unravelled a fraud stretched across 40-states and resulted in a $150 million settlement — the largest for healthcare fraud in history.
Monday, Maxim agreed to return $121.5 million in state and federal claims; $8.4 million to the VA, and pay a $20 million fine.
For exposing the fraud West will receive $15.4 million. He told the Ledger it wasn’t tough figuring out the scam. “The hard part,” he said, “was turning them in.”
Nine people, including three senior managers have pleaded guilty to felony charges, but no top executives have been charged.
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