WellCare to pay an $80 million settlement in Florida health care fraud

WellCare to pay an $80 million settlement in Florida health care fraud

According to a statement from the US Attorney's office, WellCare Health Plans Inc. - charged in a plot to defraud the Florida Medicaid program and the Florida Healthy Kids Corp, since 2007 - has agreed to pay the office $80 million as part of a deferred prosecution agreement.

The deferred prosecution agreement gives the Tampa, Florida-based WellCare the option of abiding by certain obligations so as to avert conviction in the supposed $40 million fraud, by inappropriately over-stating its health care expenditure, from mid-2002 to 2006, in the Florida benefits programs for nearly 2.5 million low-income adults and children.

As per the settlement agreement, WellCare will make a $40 million payment in reimbursement to the Florida agencies; while the other $40 million pertains to civil forfeiture.

The other requirements that WellCare also agreed to accept under the deferred prosecution agreement include - complete accountability for the demeanor that initiated the government probe; retention of and payment to an independent monitor for reviewing its business operations; cooperation with the government's current federal and state criminal investigation of ex-WellCare executives and employees.

Talking about the agreement, US attorney A Brian Albritton, said that it "serves as a wake up call for the corporate community to evaluate the effectiveness of their compliance plans to prevent criminal violations before they occur."

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