Former Wellcare Executives Found Guilty of Fraud Charges

Four WellCare Executives were found guilty on several criminal counts in a case that started, in part, with a whistleblower suit filed by James Hoyer Law Firm client Clark Bolton.  Qui tam cases filed by Bolton and three other whistleblowers led to a civil settlement of $137.5 million between the Department of Justice and WellCare.  That settlement resolved claims that WellCare overcharged Medicaid and knowingly kept over-payments from Florida’s Medicaid program.

The criminal trial now brings the case full circle with this jury verdict. The four WellCare Corporate Executives were charged with multiple counts of medical fraud, conspiracy and making false statements.  While the defendants were found guilty of medical fraud, the jury was unable to reach verdicts on the conspiracy charges.

The Tampa Tribune reports that the trial of the four former WellCare executives on federal Medicaid fraud charges lasted two-and-a-half months. Prosecutors listed more than 100 witnesses and presented reams of evidence in the forms of emails and electronic spreadsheets and accounting ledgers.

Those charged in the case were former WellCare Chief Executive Officer Todd Farha; Chief Financial Officer Paul Behrens; William Kale, vice president of Harmony Behavioral Health, a WellCare subsidiary; and Peter Clay, vice president of medical operations.

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