WellCare HMOs to pay $35.2M for overstating past profits

Insurer pays hefty sum for misrepresenting profits. Source: TAF Education Fund

WellCare Health Plans has agreed to pay $35.2 million to the U.S. Attorney in Florida after overstating its profits for three-and-a-half years.

According to The Associated Press, in a form 8-K filing with the Securities and Exchange Commission Aug. 18, WellCare agreed to the payment, which will be made by two HMOs operated by WellCare, WellCare of Florida and HealthEase of Florida. It is not a settlement of any legal cases, according to the payor.

Of the total amount, $24.5 million will be distributed to federal and state agencies, and $10.7 million will be held in an escrow account until all claims by the United States and the state of Florida against WellCare are resolved.

The AP reported that the federal government has been investigating the Tampa, Fla.-based company since late October 2007, when agents from the FBI, Department of Health and Human Services and the Medicare fraud division of the Florida Attorney General's office raided the company’s headquarters.

The Florida Agency for Health Care Administration and the Florida Attorney General's Medicaid Fraud Control Unit approved the agreement.