Disabled Vet Gets $15M for Exposing Medicaid Fraud

His health care provider billed for services it never provided
By John Johnson,  Newser Staff
Posted Sep 14, 2011 5:01 PM CDT

(Newser) – A case of Medicaid fraud with the perfect ending: A 63-year-old disabled vet in New Jersey is $15 million richer because he figured out that his health care provider was cooking the books, reports the New York Post. Robert West got suspicious when he went to the dentist and was told his Medicaid benefits had maxed out. He went home, combed through his records, and realized that Maxim Healthcare had billed the government for hundreds of hours of nursing care he never received.

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He made some phone calls to government agencies and got nowhere, then hired his own lawyer. The result? Maxim just agreed to a $150 million settlement for defrauding not only Medicaid but Veterans Affairs, and West got $15 million of that for his whistleblower's share. It's such a great story that various state and federal agencies are arguing about who should get the credit, notes the New Jersey Star-Ledger. (Hint: All credit goes to West.)

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