Executives and employees at WellCare Health Plans Inc. engaged in an elaborate scheme to defraud the Florida Medicaid program and the Florida Healthy Kids Corporation, according to a press release by the U.S. Department of Justice. In order to avoid a health care fraud conviction on these charges WellCare must, among other things, consent to the civil forfeiture of $40,000,000 and pay an additional $40,000,000 in restitution to the Florida Medicaid and Healthy Kids programs to repay proceeds from those programs to which WellCare was not entitled, according to the release.
The St. Petersburg Times newspaper described this investigation in a May 6 online article as “one of the largest health care fraud cases in the United States.”
To read the press release, go to: http://www.usdoj.gov/usao/flm/pr/2009/may/20090505_WELLCARE_Tpa_HCFraudDPA.pdf. To read the St. Petersburg Times article, go to: http://www.tampabay.com/news/business/article998325.ece. And for more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA.