Three WellCare executives were sentenced to federal prison in mid-June, with sentences ranging from a year-and-a-day to three years. The men were convicted by a jury last summer of submitting false expenditure reports to the Florida State Medicaid program in 2006. One executive was also convicted on two other charges of making false statements related to healthcare matters. 
Medicaid fraud is a serious crime that comes at a significant cost to taxpayers. The actions of these three men may have caused losses of as much as $30 million, but their attorneys argued that this was just a fraction of the billions that the company was paid. A loss of $30 million is not a small loss at a time when healthcare expenses are one of the biggest threats to the ongoing financial solvency of the United States. Those who learn of Medicaid fraud should speak out to stop this behavior. An experienced Medicaid fraud attorney in Texas should be consulted for help taking action.
Executives Defraud Medicaid of Millions
WellCare was paid by Florida’s Agency for Health Care Administration to manage health care for Medicaid recipients. The company was aware that 80 percent of the funds it was paid had to be used on services. If it fell short of this number, it would be required to return the difference to the state. To avoid having to give back the money, the executives conspired to inflate the amount of money spent on administration. This reduced the amount that WellCare was required to give back.
Unfortunately use-it-or-lose it contracts of this nature not only encourage the potential for fraud but can also incentivize wasteful behavior and inflated administrative costs. The actions of the executives were discovered and the three men now must face the consequences. However, the sentences that they ultimately received were far lower than the federal sentencing guidelines allowed. Prosecutors had asked the judge to impose harsher sentences to deter future bad behavior. The executive sentenced to three years of prison time, for example, faced a potential term of incarceration between 10 and 12 1/2 years according to the Tampa Bay Times.
The attorney representing the executive however, indicated the men were not at risk of re-offending and that their reputations were damaged and career prospects diminished. It was argued that “no sentences could punish them more than they’ve already been punished.” Of course, this is untrue and the men got off very easily for stealing millions of dollars from tax payers.
Medicaid fraud should not be tolerated on any level and those who perpetrate schemes to steal healthcare funds meant to provide care to the poor deserve to go to prison. With such light criminal sentences, the threat of criminal charges may not be a strong enough deterrent for Medicaid fraud. When whistleblowers come forward, however, the government can take action to try to recover money that was unlawfully paid. Whistleblowers may also recover a portion of the money that the federal government is able to recover.
Contact a Medicaid fraud attorney if you believe you have evidence of fraud. Call Brewer & Prichard P.C. today at 800-445-8710 or visit http://www.bplaw.com to schedule a consultation.