Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Former WellCare employee testifies on role in Medicaid fraud

TAMPA — A former WellCare employee charged with Medicaid fraud testified Thursday that the company's former top executives orchestrated the plan to keep millions of dollars that should have gone back to the state.

Gregory West, who was a senior financial planner, testified in federal district court that the company had sent false information to the state Agency for Health Care Administration. The documents outlined how much state money the company spent on mental health services for patients insured through WellCare's HMOs.

When asked how he knew the information in the documents was false, West said, "Because I had to calculate it."

West, who said he was acting at the behest of higher-ups, pleaded guilty to charges of conspiracy to commit Medicaid fraud in 2007 and agreed to cooperate with federal prosecutors in an effort to get a lighter punishment. He has not yet been sentenced.

His testimony in the three-month trial is scheduled to continue next week. Defense lawyers are expected to begin questioning him mid-week.

Former chief executive officer Todd Farha and four other former executives — former general counsel Thaddeus Bereday, former chief financial officer Paul L. Behrens and former vice presidents William Kale and Peter Clay — were indicted in 2011 on charges of conspiracy to commit Medicaid fraud and making false statements. Bereday is being tried separately.

The indictment says WellCare, based in Tampa, took Medicaid money from the state with the understanding that if it did not use 80 percent of the funds allotted for behavioral health services, the difference was to be returned to the state.

But, prosecutors said, WellCare executives conspired to inflate what they actually spent in order to reduce the amount they had to return. That strategy involved the creation of a new company, which WellCare's two Florida HMOs paid for behavioral services, to inflate costs, court documents say.

Prosecutors say WellCare shortchanged the state by at least $30 million.

Defense attorneys say the expenses were legitimate and that the state knew all along about the arrangement but failed to give WellCare any guidance.

The company paid $80 million in May 2009 and reached a civil settlement with the Department of Justice for $137 million in 2010. A whistleblower put profits of the alleged fraud between $400 million and $600 million.

West testified Thursday that he began working on the state reports around 2004. He said a lower-ranking financial analyst had come to him, holding a two-inch thick folder of documents and pleading for help. "His hands shook the whole time he talked to me," West said.

Part of the way that WellCare inflated its service costs — and therefore decreased what it had to refund to the state — was by including items that had nothing to do with behavioral health, West said.

He said two federal agents had shown up at his home the night before they raided WellCare offices in October 2007. He agreed to speak with them for two hours that evening though he said they did not tell him about the coming office raid.

During that raid, agents herded employees into a conference room and called them out, one-by-one, for interviews. West said he was interviewed again that day.

Asked why he agreed to plead guilty, he said he wanted "to tell the truth no matter what ... and let the chips fall as they may." He added he wanted "to reduce how many chips fall on me."

Jodie Tillman can be reached at or (813) 226-3374.

Former WellCare employee testifies on role in Medicaid fraud 03/07/13 [Last modified: Thursday, March 7, 2013 9:30pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Comedian and activist Dick Gregory dies at 84


    The comedian Dick Gregory rose to national prominence in the early 1960s as a black satirist whose audacious style of humor was biting, subversive and topical, mostly centered on current events, politics and above all, racial tensions. His trademark was the searing punchline.

    Dick Gregory, a comedian, activist and author, died Saturday. [Tribune News Service, 2011]
  2. Winter Haven police investigating armed robbery at Dollar General


    WINTER HAVEN — Police are investigating an armed robbery Friday night of a Dollar General store on W Lake Ruby Drive.

  3. Rowdies settle for draw at home


    ST. PETERSBURG — The good news for the Rowdies is that they still haven't lost a game at Al Lang Stadium since late April. The bad news is they had to settle for a 1-1 tie against Ottawa on Saturday night in front of 6,710 sweaty fans.

  4. Bats come to life, but Rays' freefall continues (w/video)

    The Heater

    ST. PETERSBURG —The six runs seemed like a ton, just the second time the Rays had scored that many in a game during their numbing two-plus-weeks stretch of offensive impotency, and amazingly, the first time at the Trop in nearly two months.

    Lucas Duda connects for a two-run home run in the sixth, getting the Rays within 7-5. A Logan Morrison home run in the ninth made it 7-6, but Tampa Bay couldn’t complete the comeback.
  5. 'Free speech rally' cut short after massive counterprotest


    BOSTON — Thousands of demonstrators chanting anti-Nazi slogans converged Saturday on downtown Boston in a boisterous repudiation of white nationalism, dwarfing a small group of conservatives who cut short their planned "free speech rally" a week after a gathering of hate groups led to bloodshed in Virginia.

    Thousands of people march against a “free speech rally” planned Saturday in Boston. About 40,000 people were in attendance.