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Charges Filed Against WellCare Health Plans, Inc.; WellCare Enters Into Deferred Prosecution Agreement, Agrees to Pay $80 Million in Restitution and Forfeiture
Date:5/5/2009

TAMPA, Fla., May 5 /PRNewswire-USNewswire/ -- U.S. Attorney A. Brian Albritton announces the filing of an information against and a Deferred Prosecution Agreement concerning WellCare Health Plans, Inc. (WellCare). The Information charges WellCare with engaging, through its executives and employees, in an elaborate scheme to defraud the Florida Medicaid program and the Florida Healthy Kids Corporation ("Healthy Kids" or FHKC) program of approximately $40,000,000. The Deferred Prosecution Agreement (DPA) will allow WellCare to avoid a health care fraud conviction on the charges in the information if it complies with the DPA's stringent requirements.

The DPA requires WellCare to, among other things:

(1) consent to the civil forfeiture of $40,000,000;

(2) pay an additional $40,000,000 in restitution to the Florida Medicaid and Healthy Kids programs to repay proceeds from those programs to which WellCare was not entitled;

(3) accept and acknowledge full responsibility for the conduct that led to the government's investigation of WellCare;

(4) retain and pay an independent monitor, who will be selected by the U.S. Attorney's Office and who will review and monitor WellCare's business operations and regularly report concerning WellCare's compliance with all federal and state health care laws, regulations, and programs;

(5) continue cooperating in the government's ongoing federal and state criminal investigation of former WellCare executives and employees responsible for the alleged fraudulent conduct at issue;

(6) implement, within 60 days, updated policies and procedures designed to ensure that WellCare completely and accurately reports all federal and state health care program information; and

(7) continue to develop and operate an effective corporate compliance and governance program that includes adequate internal controls to prevent recurrence of any imprope
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SOURCE U.S. Department of Justice
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