Medical health insurance: someone may be cashing in on you

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Wheelchair-Bound Vietnam Vet Uncovers Multimillion Dollar Medicaid Fraud

September 14, 2011 | NewsCore

TUCKERTON, N.J. –  A wheelchair-bound Vietnam veteran with muscular dystrophy, from New Jersey, was enjoying his $15 million whistleblower reward Wednesday, after he uncovered a multimillion dollar medical aid fraud.

Richard West, 63, of Tuckerton, first found his Medicaid benefits were wrongly maxed out in 2004 during a visit to the dentist and spent the past seven years investigating the scam, the New York Post reported.

Following the dentist visit, West returned home and examined his own records, when he found Maxim Healthcare -- the agency that provides his health aides -- had billed the government for care he never got, including visits from nurses he never met.

After spending months trying to get government officials to investigate the scam, he hired a lawyer and filed a federal lawsuit. His efforts resulted in the largest financial settlement in home healthcare fraud history.

West said, "From my wheelchair, on a ventilator and oxygen, I have spent the last seven years in this fight. Sometimes, the good guy wins."

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"The more I uncovered, the more pissed off I got that someone was making money on my disability. It's people like me that will keep these big companies honest," he added.

Maxim -- which has 300 offices in 40 states across the US -- was found to have made $61 million from phony reimbursements.

The company agreed to pay $121.5 million in reimbursements and penalties for the fake Medicaid claims and $8.4 million to the Veterans Administration. It was also fined $20 million.

West received $15 million for his efforts, as under federal law he was entitled to a percentage of the cash the company was ordered to pay back. He said he will spend his new millions on a new van, home improvements and donations to charities for the disabled.

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Linkback: https://tubagbohol.mikeligalig.com/index.php?topic=43550.0