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Medicaid probe at WellCare Health Plans leads to $32.5 million payment
Tampa Bay Business Journal - by Margie Manning
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WellCare Health Plans Inc. said it has an agreement with state and federal officials to pay $32.5 million as part of an investigation into the company’s Medicaid contract with the state of Florida.
The payment is based on an estimate of the total potential amount of refunds that two WellCare subsidiaries might owe to the Florida
Agency for Health Care Administration, according to a filing with the Securities and Exchange Commission. It does not include any interest, fines, penalties or other assessments that may be imposed on WellCare, the filing said.
WellCare (NYSE: WCG), which provides managed care services for government-sponsored health care plans, disclosed July 21 that it had
found accounting errors related to contracts with AHCA, the
Florida Healthy Kids Corp. and the Illinois Department of Health and Family Services. The company said it owed as much as $46.5 million in refunds under those contracts and it would restate earnings for 2004, 2005, 2006 and the first half of 2007 as a result.
WellCare said in its SEC filing late Monday that it was acknowledging and agreeing its two Florida HMOs, WellCare of Florida Inc. and HealthEase of Florida Inc., would make a payment of not less than a total of $24.5 5 million to the financial litigation unit of the U.S. Attorney’s Office for the Middle District of Florida. The U.S. attorney, AHCA and the Florida Attorney General’s Medicaid Fraud Control Unit are authorized to access and distribute the $24.5 million to appropriate federal and state agencies, the filing said.
The remaining $10.7 million paid by WellCare will be held in escrow, pending resolution of all federal and related state claims. The amount held in escrow does not limit the ability to federal or state authorities to recovery additional amounts, the filing said.
The agreement is not a settlement or release of any civil or administrative claims against the company, and is not a concession that WellCare is entitled to any limitation of its potential liability, the filing said. The company said it continues to cooperate with investigators who are involved in a probe that became public when federal and state authorities raided WellCare’s Tampa headquarters in October.
At least one analyst said the development bodes well for the company, which is among the largest publicly traded firms based in the Tampa Bay area.
“There is now more than enough evidence to conclude that a catastrophic outcome is now very unlikely for WellCare,” Carl McDonald, an analyst with Oppenheimer & Co., wrote in a note to clients, according to a report on Bloomberg News.