Whistleblower tips against Wellcare leads to criminal case showing vast Medicaid Abuse

Sean Hellein, a WellCare financial analyst became a whistleblower and worked with the FBI wearing a wire, secretly recording 650 hours of conversations culminating in a pending criminal prosecution against the former CEO Todd Farha. His tips have revealed a vast plot to defraud Medicaid in Florida. Under law, the companies are supposed to spend at least 80 percent of the money Medicaid gives them for mental health care directly on patients. The remaining 20 percent is for other costs and profits. U.S. prosecutors say that Wellcare’s execs set out to avoid making refunds under the 80/20 law, inflated patient  spending reports to the state and set up a subsidiary to hide money from Florida regulators. According to court papers, the company failed to pay $40 million in refunds. Wellcare has paid $427.50 million in settlements and whistleblower Hellein was paid $20.7 million under the False Claims Act. Jeffrey Newman represents whistleblowers. jeffrey.newman1@gmail.com