Wednesday, June 12, 2013

WellCare executives convicted in fraud trial


Last Modified: Tuesday, June 11, 2013 at 4:46 p.m.

TAMPA, Fla. - Four former WellCare executives have been convicted of some, but not all, charges following a Medicaid fraud trial in Florida.
WellCare CEO Todd Farha, WellCare CFO Paul Behrens, Harmony Behavioral Health vice president William Kale and vice president of operations Peter Clay all faced multiple counts of medical fraud, conspiracy and making false statements. But after several weeks of deliberations, jurors in Tampa told U.S. District Judge James Moody on Monday that they were unable to reach verdicts for the more serious charge of conspiracy to commit medical fraud on each defendant.
Farha was found guilty of two counts of health care fraud, and acquitted of six other charges including giving false statements. Behrens also was found guilty of two counts of health care fraud and two counts of making false statements, but was acquitted of other two other false statement charges. Kale was found guilty of two counts of health care fraud and Clay was found guilty of two counts of making false statements.
Prosecutors say they haven't decided whether to retry to deadlocked conspiracy counts.
A sentencing date hasn't been set. On each of the health care fraud counts, Farha, Behrens and Kale face up to 10 years in prison. The other charges carry a maximum of five years.
Prosecutors say the four men defrauded the government out of more than $30 million. Dealing exclusively with Medicare and Medicaid claims, authorities say the executives produced false documents and formed Harmony Behavioral as a "shell company" to inflate the costs for behavioral health-care services.
Defense attorneys say the expenses were legitimate. They say the state knew about the arrangement but failed to give WellCare and other companies any guidance. They accused federal prosecutors turning a contractual dispute into a federal crime.

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