[Tampa, FL] A Tampa health-care giant is finally settling up and hoping to move on, after many years of bad press and even-worse realities surrounding Florida Medicare fraud and the just-resolved federal case that ensnared its highest executives.
WellCare Health Plans said Friday it has finalized settlements with federal officials that will lead to it paying $137.5 million in a health-care fraud case. WellCare reached agreement in 2010 with the federal government, but final approval was held up by a whistleblower who had objected.
The whistleblower worked with the Justice Department as part of an undercover operation at WellCare. That operation lasted for 18 months.
The Tampa-based HMO said Friday the whistleblower withdrew his objection, allowing resolution of the case. The case emerged in 2007, when federal agents raided the company‘s headquarters after an investigation that included whistleblower information.
Ann March of last year, five former executives of WellCare Health were indicted on charges of fraud by United States Attorney Robert E. O’Neill for the Middle District of Florida.
According to that indictment, “beginning in July 2003 and continuing until October 24, 2007, the defendants, all former executives of WellCare Health Plans, Inc. … conspired to, and engaged in, a scheme to defraud the Florida Medicaid program by making false and fraudulent statements relating to expenditure information for behavioral health care services.”
Yikes. Listed on that indictment: former Chief Executive Officer Todd S. Farha, former General Counsel Thaddeus M.S. Bereday, former Chief Financial Office Paul L. Behrens, former Vice President of Harmony Behavioral Health (a wholly-owned subsidiary of WellCare) William L. Kale and former Vice President of Medical Economics Peter E. Clay.
Another former WellCare higher-up, former board member Regina Herzlinger, has gone public with her criticism of the company, penning op-eds and basically taking the company where it doesn’t want to go.
Herzlinger points out that WellCare has, “the lowest Medicare quality scores and the most fines and sanctions recently among its peers and, as the chair of the audit committee. I knew just how fragile its accounting system was.”
Nonetheless, the company is trying desperately to put all of this behind them.
“We are pleased that these matters are fully resolved,” Alec Cunningham, WellCare’s chief executive officer, said in a news release about the $137.5 million fine. “WellCare is a transformed company that is focused on providing quality, cost-effective health care solutions for our members, providers and government customers.”
By: Mark Christopher/Sunshine Slate. Additional reporting by The News Service of Florida
WellCare to Report First Quarter 2012 Results on May 2 (Reuters) WellCare Health Plans, Inc. (NYSE: WCG) will report on Wednesday, May 2, 2012, at 6:30 am Eastern Time its results for the quarter ended March 31, 2012. Beginning at 9:00 am Eastern Time the same day, Alec Cunningham, …