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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

the remaining balance of $19,800,000 by Dec. 31, 2009 (and will make its best efforts to pay that balance as soon as possible).

The DPA will be in effect for three years, but the USAO can reduce that term to two years based upon consideration of:

(a) WellCare's continued remedial actions;

(b) WellCare's compliance with all federal and state health care laws and regulations;

(c) the independent monitor's written reports regarding WellCare's compliance; and

(d) WellCare's satisfaction of all of its obligations under the DPA.

The DPA further provides that if WellCare complies with the DPA, the USAO will move within five days of the DPA's expiration to dismiss with prejudice the Information filed against WellCare.

U.S. Attorney A. Brian Albritton stated, regarding the WellCare Information and DPA: "Health care providers must be held accountable for Medicaid fraud abuse. In this case, we will recover $80,000,000 from WellCare, twice the amount involved in the fraud, and we are continuing to pursue criminal charges against individuals. This information and DPA serve as a wake up call for the corporate community to evaluate the effectiveness of their compliance plans to prevent criminal violations before they occur. WellCare's compliance program failed to prevent the misconduct alleged in the information, and as a result, WellCare has been charged with a felony."

FBI Special Agent-in-Charge Steven E. Ibison said: "In this case, corporate greed was responsible for the theft of funds from critical government programs. These programs were designed to facilitate health care services to adult citizens and children who otherwise would not be able to afford needed treatments. The company executives and employees allegedly responsible for defrauding Medicaid and other health care programs in Florida had a choice, to help or steal, and they chose the latter. The investigation o
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SOURCE U.S. Department of Justice
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