WellCare to pay $80M in restitution in Florida case
TAMPA, Fla. — Florida's largest Medicaid managed care provider will be allowed to avoid criminal prosecution for health care fraud if it pays $80 million in restitution, under an agreement announced today by the U.S. Attorney's Office.
Tampa-based WellCare Health Plans Inc. has been charged with engaging in an elaborate scheme to defraud the Florida Medicaid program and Florida Healthy Kids Corporation of about $40 million. WellCare also has operations in seven other states, including Hawai'i, that were not involved in the wrongdoing.
U.S. Attorney A. Brian Albritton said he is confident prosecutors could convict WellCare, but that doing so would likely put the insurer out of business, harming Floridians who depend on the company for health care. He also said authorities did not want to put hundreds of innocent employees out of work and hurt the company's shareholders.
"In charging WellCare, we have sought to punish the company for its misconduct," Albritton said at a news conference in Tampa. "But we have, at the same time, tried to avoid crushing it."
WellCare manages care for nearly 2.4 million people on government-sponsored health plans in Florida, Connecticut, Georgia, Hawai'i, Illinois, Missouri, New York and Ohio. In Hawai'i it operates under the 'Ohana Health Plan name and is one of two contractors providing services under the state's new Quest Expanded Access Medicaid program.