The states involved are Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Missouri, New York and Ohio. The whistle-blowers who brought the suits will also receive a percentage of the payments.
WellCare came under civil and criminal investigation in 2006 after allegations arose that it had engaged in a number of fraudulent activities, including inflating the costs of medical care, pocketing overpayments it had received for infant care, misrepresenting patients' medical conditions and treatments, and operating a sham Special Investigations Unit, among other practices.
This is the second settlement the managed-care contractor has entered into to settle the charges. In May 2009, WellCare paid $40 million in restitution and forfeited $40 million under a deferred prosecution agreement with the U.S. attorney's office.
Separately, WellCare said that the U.S. attorney for the Middle District of Florida and the Florida Attorney General's Office have agreed to an early termination of the May 2009 deferred-prosecution agreement. The early termination indicates that the company has met its obligations, and the criminal charges against the company will be dismissed within five days.
Several former WellCare employees are also awaiting trial on criminal charges; one former analyst, Gregory West, has already pleaded guilty to a conspiracy charge and is awaiting sentencing.
Three of the suits were brought in the Middle District of Florida and one in the District of Columbia.