A Medical Device Daily

WellCare Health Plans (Tampa, Florida) said it has resolved investigations by the U.S. Attorney's Office (USAO) for the Middle District of Florida and the Florida Attorney General's Office by entering into a deferred prosecution agreement (DPA). Under the DPA, the USAO has filed a one-count criminal information charging the company with conspiracy to commit healthcare fraud against the Florida Medicaid and Healthy Kids programs under certain contracts.

WellCare will pay a total of $80 million; the company paid $35.2 million of that amount in August. WellCare agreed to pay $25 million within five business days of the entry of the DPA and the remaining $19.8 million no later than Dec. 31.

According to WellCare, the USAO has agreed to recommend to the court that prosecution of WellCare be deferred for the term of the DPA. If the company complies with the DPA, the USAO will seek dismissal of the charges within five days of its expiration.

"We are pleased to have reached this resolution," said Heath Schiesser, president/CEO of WellCare. "Over the past year, the company has developed a comprehensive compliance program that will provide a solid foundation for WellCare's future. It is an honor and a privilege to serve our country's Medicare and Medicaid population, and we remain committed to offering valuable health plan options that provide quality care for our members while easing the financial burden on the government programs we serve."

According to Charles Berg, the company's executive chairman, WellCare has "cooperated fully in these matters and the board of directors is very pleased that they have been resolved. Compliance with all of the laws and regulations governing WellCare's business is a top priority, not only for our senior leadership team, but for all of our associates."

The DPA requires WellCare to retain an independent monitor, selected by the USAO, for 18 months.

WellCare provides managed care services exclusively for government-sponsored healthcare programs, focusing on Medicare and Medicaid.