Attorney General Pam Bondi News Release

April 4, 2012
Contact: Whitney Ray
Phone: (850) 245-0150

Florida Recovers More Than $54 Million From WellCare in Medicaid Fraud Settlement

TALLAHASSEE, Fla.–Attorney General Pam Bondi today announced that Florida has recovered more than $54 million in an agreement with WellCare that resolves allegations of accounting fraud and the falsification of records. A National Association of Medicaid Fraud Control Unit team, led by the Florida Attorney General’s Office, investigated the allegations and negotiated with WellCare on behalf of the settling states. Connecticut, Georgia, Hawaii, Illinois, Indiana, Missouri, New York, Ohio, and the federal government also joined the total $137.5 million settlement. Today’s settlement is in addition to an $80 million deferred prosecution agreement that the Florida Attorney General’s Office and the federal government entered into with WellCare in May 2009. The DPA required WellCare to pay $40 million in civil forfeiture and $40 million in restitution for damages to Florida Medicaid and the Florida Healthy Kids program.

“This settlement results from collaboration among states and the federal government to ensure that Medicaid funds go only toward payments for legitimate services,” stated Attorney General Pam Bondi. “WellCare, like every other organization that receives Medicaid dollars, is responsible for accurate accounting and only submitting genuine claims to the Medicaid program. We have worked diligently to recover money on behalf of Floridians.”

Additionally, the settlement also requires WellCare to enter into a Corporate Integrity Agreement with the Office of the Inspector General of the Department of Health and Human Services. HHS will oversee the corporation’s rehabilitation for three years.

The investigation involved five whistleblower lawsuits filed under the qui tam provisions of the federal and certain state False Claims Acts. These actions are pending in the United States District Court for the District of Connecticut, the Middle District of Florida and the State of Florida Second Circuit.