Saturday, May 26, 2018
News Roundup

Jurors deliberating in former WellCare execs' fraud trial

TAMPA — The fate of four former WellCare executives accused of defrauding the state Medicaid program of nearly $30 million now rests in the hands of a federal jury.

After a nearly 2 1/2-month trial, attorneys on Tuesday finished their closing statements in the high-profile criminal case against former chief executive officer Todd S. Farha; former chief financial officer Paul L. Behrens; former vice president William Kale; and former vice president Peter E. Clay.

Jurors are scheduled to begin deliberations today.

The defendants face charges of conspiracy to commit Medicaid fraud and making false statements. Clay also faces two counts of making false statements to federal agents.

If convicted, each man faces up to 10 years on the health care fraud count and up to five years on other counts.

Federal prosecutors say the men led a scheme to keep public dollars that should have gone back to the state. According to the March 2011 indictment, WellCare took Medicaid money from Florida's Agency for Health Care Administration with the understanding that if it did not use 80 percent of the funds set aside for behavioral health services, the difference was to be returned to the state.

But, prosecutors say, WellCare executives conspired to inflate what they actually spent 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.

Defense attorneys say the expenses were legitimate and that the state Agency for Health Care Administration knew all along about the arrangement but failed to give WellCare and other HMOs any guidance. They say federal prosecutors worked themselves into a corner with a highly publicized raid of WellCare headquarters in 2007 and turned a contractual dispute into a federal crime.

The prosecutors' case against the executives included hours of internal meetings secretly taped by whistle-blower Sean Hellein as well as testimony from Gregory West, a senior financial planner who testified he sent false information to the state at the behest of his bosses.

West 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.

Defense attorneys undercut West's testimony, saying he testified about matters he did not understand in an attempt to save himself from prison time. Attorney Peter George said Monday that WellCare executives reported information to the state based on their interpretation of the law governing Medicaid behavioral services.

He told jurors that snippets of recordings or emails showing that executives, including his client Farha, were concerned about how much money they had to refund the state were not unusual.

"Saving money was part of Mr. Farha's job," he said.

Assistant U.S. Attorney Jay Trezevant said Tuesday that defense lawyers had done little other than present "red herrings" to distract jurors from the real issue.

"They were making up numbers and sending bogus information to AHCA," he said.

Jodie Tillman can be reached at [email protected] or (813) 226-3374.

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