- The Washington Times - Sunday, February 11, 2007

U.S. Department of Justice criminal division lawyers say a Reston-based government consulting company either “willfully or recklessly” submitted inaccurate Medicaid claims on behalf of the D.C. government, the company recently disclosed.

Officials with Maximus Inc. said in a recent Securities and Exchange Commission (SEC) filing that they disagree with the criminal division lawyers’ assessment. The company also said it is engaged in ongoing talks with the Justice Department concerning a potential civil settlement, the SEC filing states.

Federal authorities began investigating Maximus’ work for the District more than two years ago.

Though not outlined in the SEC filings, unsealed court records show that investigators have reviewed accusations in a False Claims Act lawsuit in which a former employee says the company overcharged the government tens of millions of dollars while Maximus was working for the District’s foster care agency.

No charges have been filed against the company. Last week, Maximus first disclosed in SEC filings that Justice Department criminal division lawyers “have expressed their view that the company either willfully or recklessly submitted inaccurate claims to the federal government on behalf of the District of Columbia.”

“Maximus disputes that view,” company officials said. “Nevertheless, the criminal division attorneys have referred the company to attorneys for the civil division to determine if a civil resolution of the matter is possible. Those discussions are ongoing.”

A spokesman for Jeffrey A. Taylor, U.S. attorney for the District, on Friday declined to comment, saying the matter is pending. There is no indication from Maximus’ latest SEC filing that the criminal probe has concluded.

Maximus officials could not be reached for comment Friday. Previously, a company spokeswoman said the company has been cooperating with federal authorities and would not want to jeopardize its efforts by making individuals available for interviews.

In previous SEC filings in 2004 and 2005, Maximus officials said they don’t believe the company broke any federal health care laws in connection with the federal investigation.

The SEC filing last week does not specify the scope of the investigation into Maximus’ work for the District, beyond stating it is related to “issues pertaining to compliance with federal laws governing Medicaid claims.”

The Washington Times reported last year that federal authorities started investigating Maximus after a former employee accused the company of submitting questionable Medicaid claims totaling approximately $33 million while working for the D.C. Child and Family Services Agency.

Under the consulting arrangement, Maximus was paid 10 cents of every Medicaid dollar it helped the city recoup, eventually netting the company more than $3 million for at least $30 million in Medicaid claims, according to the lawsuit.

However, the 2003 False Claims Act lawsuit filed against Maximus by former employee Benjamin Turner says the Medicaid-billing project was “grounded in fraud.”

A billing review found more than half of the foster children for whom Maximus prepared Medicaid claims had no record of actually having received services, according to the suit.

In addition, the lawsuit said the D.C. government, unaware of the purported mischarging, lost more than $3 million.

Previously, Maximus has declined to comment on Mr. Turner’s lawsuit, saying it has not been served with the complaint and that public records show the suit was ultimately dismissed from Alexandria federal court in June 2005.

Within days of the lawsuit’s dismissal in Alexandria, unsealed filings in Mr. Turner’s case show that his complaint was filed in D.C. federal court on June 21, 2005.

No records of the case appear on the public docket in federal court in the District. False Claims Act complaints usually are kept under seal until dismissal or until the Justice Department decides whether to take over prosecution of the case.

In the latest filing last week, Maximus said it cannot predict how much the investigation could cost the company beyond $500,000 already set aside for an internal review.

“We are unable to quantify the probability of criminal or civil prosecution or the probability or magnitude of any other expenditure, fine, penalty or settlement,” Maximus officials wrote.

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