Whistleblower’s complaint about WellCare Health Plans unsealed

By Carol Gentry and Mike Wells
June 27, 2010 © Health News Florida

The complaint that launched a federal investigation of WellCare Health Plans four years ago by a whistleblower within the company has now been unsealed, and the picture it paints of the state’s largest Medicaid HMO contractor is grim.The complaint, filed by former WellCare financial analyst Sean J. Hellein, portrays a company so ethically challenged that it rewarded employees who dumped hundreds of sick newborns and terminally ill patients from the membership rolls, thereby pumping up profits by millions of dollars.

It describes a company that embraced fraudulent accounting as a business model, eventually stealing between $400 million and $600 million from Medicare and Medicaid programs in several states, perhaps most of it from Florida.

These “ill-gotten gains were taken by deceiving, outsmarting and concealing the truth from government regulators,” said Hellein’s attorney Barry Cohen in a press release Friday.

WellCare has not yet issued a response, but has in the past has termed what occurred “accounting errors.”

Cohen persuaded U.S. District Court Judge James S. Moody to unseal the records on Thursday after learning that the U.S. Attorney’s Office was discussing settling the case with WellCare for $137.5 million.

Read the rest of the story here.