- 795
Could this spell the end of the gravy train?
FBI Raids WellCare's Tampa Office
By Elaine Silvestrini of The Tampa Tribune
Published: October 24, 2007
TAMPA - A national insurance company's local office is the subject of an FBI raid this morning, authorities said.
The Hillsborough County Sheriff's Office was notified about the raid at WellCare Health Plans, but it is not assisting, said sheriff's spokeswoman Debbie Carter.
"From what we were told, it's all FBI," she said.
The U.S. attorney's office issued a news release saying law enforcement personnel with the FBI, U.S. Department of Heath and Human Services-Office of
Inspector General, and the Florida attorney general's Medicaid Fraud Control Unit participated in the execution of a federal search warrant at the headquarters of
WellCare Health Plans.
On the New York Stock Exchange, trading in the company's shares was halted this morning.
WellCare has more than 2.3 million members. There are no commercial accounts; all are Medicare or Medicaid. Of those, 971,000 are Medicare drug plan
members, WellCare offers its Medicare drug plans in all 50 states and the District of Columbia. WellCare is one of the nation's largest Medicare Part D providers.
WellCare has contracts with seven state Medicaid programs, but Florida is by far WellCare's largest client, with more than 450,000 enrolled in its health plans. Of
the $1.7 billion the state paid HMOs last year, WellCare's two plans took in half, almost $850 million.
The U.S. Attorney's news release says the "ongoing investigation does not directly concern, nor should it have any impact upon, the delivery of any health care
service to any person."
The FBI referred questions to the U.S. attorney's office.
The purpose of the search at the company's office, on 8735 Henderson Road, near Waters Avenue, was not known.
FBI agents could be seen around the building this morning, and there appeared to be a large number of people leaving the parking lot. People who tried to enter the
building were turned away. Agents could be seen taking empty boxes into the facility and walking out with boxes. It was not clear what, if anything, was in the
boxes.
WellCare Health Plans is a Tampa-based company that has become a national provider of health insurance for Medicaid and Medicare patients under government
contracts.
The timing of the search comes as Congress is debating whether to eliminate funding for Medicare Advantage options.
Today, a group called The Coalition for Medicare Choices has organized a rally of seniors in the nation's capital in support of Medicare Advantage.
Democrats in control of the U.S. House of Representatives have been targeting Medicare Advantage because, they say, these private plans sold by WellCare and
other companies are paid too much by the government, exceeding costs under the traditional Medicare program.
They also have pointed to the complaints that have surfaced nationally about some misleading sales tactics tied to such programs.
These Democratic efforts have included efforts to cut funding for Medicare Advantage programs $50 billion during the next five years in a House bill that was
passed Aug. 2 to renew and expand government sponsored children's health insurance.
But the Senate version of the same bill did not call for such cuts. And the Bush administration has threatened to veto any such move.
Ultimately, the cuts contained in the House version of the bill were dropped from a final version of the bill last month.
But Democrats continue to push for similar cuts to Medicare Advantage in other legislation.
Florida GOP Reps. C.W. Bill Young and Ginny Brown-Waite have been among the staunchest defenders of Medicare Advantage; Brown-Waite has lashed out at
the AARP for supporting efforts to cut funding for these programs.
This year, nearly 8.3 million, or about one-fifth, of the aged or disabled Medicare beneficiaries nationally are enrolled in Medicare Advantage, according to the
Congressional Budget Office.
That includes 758,953 of the more than 3.1 Medicare participants in Florida.
In June, after congressional committees accused WellCare of Medicare marketing abuses, the company promised to fix its problems.
It stopped marketing its most problem-plagued plan and announced new customer protections. Todd Farha, chairman and chief executive, promised "best-in-class
compliance practices to protect seniors."
The fixes are taking longer than planned. This month, the Centers for Medicare and Medicaid Services released documents that show WellCare was cited again in
August for violating eight provisions of its Medicare contract.
The violations include some of the same sales practices the Tampa company was accused of in April and some new ones. For example, the report says the company
failed to meet the 60-day deadline on appeals from members who were denied coverage in 40 percent of the cases studied.
Company spokeswoman Amy Knapp said then that the company had complied.
"WellCare is confident that it addressed CMS' concerns in its corrective action plans and expects to receive notification from CMS that its plans have been
approved," she wrote in an e-mail.
FBI Raids WellCare's Tampa Office
By Elaine Silvestrini of The Tampa Tribune
Published: October 24, 2007
TAMPA - A national insurance company's local office is the subject of an FBI raid this morning, authorities said.
The Hillsborough County Sheriff's Office was notified about the raid at WellCare Health Plans, but it is not assisting, said sheriff's spokeswoman Debbie Carter.
"From what we were told, it's all FBI," she said.
The U.S. attorney's office issued a news release saying law enforcement personnel with the FBI, U.S. Department of Heath and Human Services-Office of
Inspector General, and the Florida attorney general's Medicaid Fraud Control Unit participated in the execution of a federal search warrant at the headquarters of
WellCare Health Plans.
On the New York Stock Exchange, trading in the company's shares was halted this morning.
WellCare has more than 2.3 million members. There are no commercial accounts; all are Medicare or Medicaid. Of those, 971,000 are Medicare drug plan
members, WellCare offers its Medicare drug plans in all 50 states and the District of Columbia. WellCare is one of the nation's largest Medicare Part D providers.
WellCare has contracts with seven state Medicaid programs, but Florida is by far WellCare's largest client, with more than 450,000 enrolled in its health plans. Of
the $1.7 billion the state paid HMOs last year, WellCare's two plans took in half, almost $850 million.
The U.S. Attorney's news release says the "ongoing investigation does not directly concern, nor should it have any impact upon, the delivery of any health care
service to any person."
The FBI referred questions to the U.S. attorney's office.
The purpose of the search at the company's office, on 8735 Henderson Road, near Waters Avenue, was not known.
FBI agents could be seen around the building this morning, and there appeared to be a large number of people leaving the parking lot. People who tried to enter the
building were turned away. Agents could be seen taking empty boxes into the facility and walking out with boxes. It was not clear what, if anything, was in the
boxes.
WellCare Health Plans is a Tampa-based company that has become a national provider of health insurance for Medicaid and Medicare patients under government
contracts.
The timing of the search comes as Congress is debating whether to eliminate funding for Medicare Advantage options.
Today, a group called The Coalition for Medicare Choices has organized a rally of seniors in the nation's capital in support of Medicare Advantage.
Democrats in control of the U.S. House of Representatives have been targeting Medicare Advantage because, they say, these private plans sold by WellCare and
other companies are paid too much by the government, exceeding costs under the traditional Medicare program.
They also have pointed to the complaints that have surfaced nationally about some misleading sales tactics tied to such programs.
These Democratic efforts have included efforts to cut funding for Medicare Advantage programs $50 billion during the next five years in a House bill that was
passed Aug. 2 to renew and expand government sponsored children's health insurance.
But the Senate version of the same bill did not call for such cuts. And the Bush administration has threatened to veto any such move.
Ultimately, the cuts contained in the House version of the bill were dropped from a final version of the bill last month.
But Democrats continue to push for similar cuts to Medicare Advantage in other legislation.
Florida GOP Reps. C.W. Bill Young and Ginny Brown-Waite have been among the staunchest defenders of Medicare Advantage; Brown-Waite has lashed out at
the AARP for supporting efforts to cut funding for these programs.
This year, nearly 8.3 million, or about one-fifth, of the aged or disabled Medicare beneficiaries nationally are enrolled in Medicare Advantage, according to the
Congressional Budget Office.
That includes 758,953 of the more than 3.1 Medicare participants in Florida.
In June, after congressional committees accused WellCare of Medicare marketing abuses, the company promised to fix its problems.
It stopped marketing its most problem-plagued plan and announced new customer protections. Todd Farha, chairman and chief executive, promised "best-in-class
compliance practices to protect seniors."
The fixes are taking longer than planned. This month, the Centers for Medicare and Medicaid Services released documents that show WellCare was cited again in
August for violating eight provisions of its Medicare contract.
The violations include some of the same sales practices the Tampa company was accused of in April and some new ones. For example, the report says the company
failed to meet the 60-day deadline on appeals from members who were denied coverage in 40 percent of the cases studied.
Company spokeswoman Amy Knapp said then that the company had complied.
"WellCare is confident that it addressed CMS' concerns in its corrective action plans and expects to receive notification from CMS that its plans have been
approved," she wrote in an e-mail.
