Monday, September 24, 2018
News Roundup

Judge sentences former WellCare execs to prison in Medicaid fraud

TAMPA — Three former WellCare executives were sentenced to federal prison Monday for their roles in a scheme to keep Medicaid money for the company that should have been returned to the state.

All three prison terms were far less than what federal sentencing guidelines recommended.

U.S. District Judge James S. Moody Jr. ordered former chief executive officer Todd Farha to serve three years in prison and pay a $50,000 fine. Former chief financial officer Paul L. Behrens received a two-year sentence and former vice president William Kale a sentence of one year, plus one day.

Prosecutors had asked the judge to impose sentences toward the high end of the federal sentencing guidelines, which, in Farha's case, called for a term of 10 to 121/2 years.

Addressing a courtroom packed with the men's families and friends, Moody said he tried to put the case into perspective. He noted that prosecutors' estimate of the loss to the Medicaid program — $30 million — is a fraction of the billions that the state paid the company over that period to manage recipients' health care.

Moody said the men posed no risk of reoffending and had seen their reputations damaged and career prospects dimmed. "No sentences could punish them more than they've already been punished," he said.

The trio remains out on bail pending appeals, due in two weeks. Attorneys for all three said they intended to appeal but also praised the sentencing decisions.

"We are grateful that Judge Moody, in imposing a sentence substantially below what the government sought, recognized the complex circumstances of this case and the true character of the people involved," said Barry Boss, an attorney for Farha.

WellCare received Medicaid money from Florida's Agency for Health Care Administration knowing that if it did not use 80 percent of the funds on services, the difference was to be returned to the state. But, prosecutors say, the executives conspired to inflate what they actually spent to reduce the amount they had to return.

All three men were convicted by a jury last summer on two counts of health care fraud for submitting false expenditure reports to the state Medicaid program in 2006. The jury also found Behrens guilty of two other charges of making false statements related to health care matters.

A fourth defendant, former vice president Peter E. Clay, was found guilty of making false statements to federal agents. He received five years of probation, plus a $10,000 fine.

Before he was sentenced, Farha, 45, told Moody that he realized he'd made "serious mistakes" and regretted the impact on his family. "Never in my life could I imagine I'd be standing here before you," he said.

Kale, whose voice cracked with emotion, said he, too, would have handled things differently. "The past six years have been a very sad and overwhelming time for me," he said.

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