News

FIFTH WELLCARE EXEC SENTENCED TO PRISON FOR FRAUD SCHEME

Thaddeus M.S. Bereday, the former general counsel for WellCare Health Plans ,has been sentenced to six months in federal prison for his role in a scheme to defraud Florida’s Medicaid program.

The Department of Justice announced that  Bereday will serve a prison sentence followed by a year of house arrest after he pleaded guilty this summer to making false statements to the Florida Medicaid Program. The court has also ordered him to pay a $50,000 fine.

WellCare said in a statement that it had fully participated in the investigation and that issues directly related to the company had been resolved, according to  Reuters, which added that Bereday’s lawyer declined to comment.

Bereday is among five former WellCare executives who were charged in 2011 for their roles in the scheme, which involved forming a separate unit to hide its Medicaid reimbursement and falsifying provider payments to circumvent a Florida law that requires insurers to spend at least 80 percent of Medicaid premiums for behavioral health on beneficiary services.  

The other four executives — former WellCare President and CEO Todd Farha, former Chief Financial Officer Paul Behrens, former Vice President of Clinical Services William Kale. and former Vice President of Medical Economics Peter Clay — were found guilty of fraud-related charges in 2013.

FierceHealthcare reported that despite the fraud case that caught its top executives, WellCare continues to profit from its Medicaid business. The insurer reported in February that it grew its Medicaid membership to 2.5 million by the end of 2016, a 6.5 percent increase from the year prior. That growth was driven in part by its acquisition of Care1st Arizona and some of Advicare Corp.’s Medicaid assets.

 

Previous post

WHAT’S UP IN THE NEW YEAR? PHYSICIANS RESPOND TO ISSUES FACING THEM IN 2018

Next post

CHINESE ROBOT PASSES CHINA’S MEDICAL LICENSING EXAM

Larry Storer

Larry Storer

No Comment

Leave a reply

Your email address will not be published. Required fields are marked *