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WellCare to pay $137.5 million

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  • | 4:16 p.m. April 3, 2012
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  • Tampa Bay-Lakeland
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TAMPA — WellCare Health Plans Inc. has agreed to pay $137.5 million to settle four lawsuits against it, the Department of Justice announced today in a news release.

The lawsuits alleged that Tampa-based WellCare, which provides managed health care services for about 2.6 million Medicare and Medicaid patients, engaged in schemes to submit false claims to Medicare and Medicaid programs.

In the settlement, announced by the U.S. Attorney's office for the Middle District of Florida, WellCare will pay the U.S. and nine states a total of $137.5 million plus interest in fixed payments over three years.

Whistleblowers who initiated the lawsuits allege that WellCare falsely inflated the amount it claimed to be spending on medical care; knowingly retained overpayments it received from Florida Medicaid for infant care; and falsified data that misrepresented the medical conditions of patients and the treatment they received, among other allegations.

This is the second settlement WellCare has agreed to since the government began investigating the company in 2006. The company's settlements now total $217.5 million.

Several criminal cases against former WellCare employees remain ongoing. Former WellCare analyst, Gregory West, pleaded guilty to a conspiracy charge and awaits sentencing. Five former executives were indicted in March 2011 and are awaiting trial, which is scheduled for January.


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