• Maxim has reached a settlement with the Massachusetts Attorney General and MassHealth to resolve an error the company identified and self-reported to MassHealth in 2016.
  • Maxim discovered and self-reported the error after MassHealth issued a notice to all providers clarifying eligibility requirements for home health services and implementing a new prior authorization process in February 2016.
  • Maxim proactively took corrective actions including retraining staff and adopting new authorization and record review protocols to strengthen its internal processes and prevent future errors.

Maxim Healthcare Services has reached a settlement with the Massachusetts Attorney General and MassHealth to resolve an error the company identified and self-reported to MassHealth in 2016.

The settlement refunds overpayments from MassHealth for home health aide services Maxim provided to certain MassHealth beneficiaries between 2010 and 2016. Maxim discovered and self-reported the error after MassHealth issued a notice to all providers clarifying eligibility requirements for home health services and implementing a new prior authorization process in February 2016.

Upon receiving the notice, Maxim began a thorough review of its practices as a MassHealth provider and ultimately determined it had misinterpreted a regulation concerning the provision of home health aide services to beneficiaries who fail to meet certain criteria. In addition to self-reporting the overpayments, Maxim proactively took corrective actions including retraining staff and adopting new authorization and record review protocols to strengthen its internal processes and prevent future errors.

Under the terms of the agreement, Maxim will pay the State of Massachusetts $14.2 million and provide additional training to all employees involved in the MassHealth billing process for a period of three years.

“Maxim is deeply committed to maintaining a strong culture of compliance and integrity and we take our obligations to MassHealth and the other programs we serve very seriously,” said Bill Butz, Maxim CEO. “While we regret this error, we are pleased we were able to identify it on our own and take the necessary steps to resolve it quickly.”

About Maxim Healthcare Services

Maxim Healthcare Services, Inc. provides home healthcare, healthcare staffing, behavioral care, and population health and wellness services across the United States. Founded in 1988, Maxim is focused on delivering quality patient care and a commitment to employee development with an emphasis on customer service. Today, Maxim is an established partner in the healthcare industry and is constantly evolving to address the needs of our patients, caregivers, and clients. Our focus on quality patient care and compliance is the foundation for our success.