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Settlement talks for WellCare whistle-blowers under way

TAMPA — Negotiations are under way in the WellCare Health Plans Inc.'s Medicare and Medicaid fraud case that may provide whistle-blowers with more money in any settlement.

A Nov. 28 federal court filing by the U.S. Attorney's Office said discovery in whistle-blower Sean Hellein's case has been suspended for 30 days to "facilitate discussions" to resolve issues.

Those include how Hellein, a senior financial analyst for WellCare, and three other whistle-blowers split their percentage of money recovered from the Tampa company.

Hellein had objected last year to the $137.5 million WellCare agreed to pay to settle lawsuits and resolve a federal investigation. His attorney, Barry Cohen, said the settlement was inadequate because the government had underestimated WellCare's fraud, which Cohen said might have been as high as $600 million.

Whistle-blowers who report such fraud are entitled to receive 15 to 25 percent of any settlement.

Cohen said in an interview Monday that current negotiations may provide Hellein a percentage of $40 million in restitution paid by WellCare in a 2009 deferred prosecution settlement with prosecutors.

That would be on top of the larger, $137.5 million settlement. The U.S. Attorney's Office declined to comment. And Cohen could not say if the $137.5 million settlement would change.

Cohen said the deferred prosecution money has been held in escrow. He said Hellein is the main whistle-blower in the case.

"We're in serious negotiations," Cohen said. "But you know how negotiations are. Sometimes they go through, and sometimes they don't."

Cohen has said more than 1,000 hours of audio and video surveillance exist during which his client was "surreptitiously capturing hundreds of incriminating admissions of the company's fraudulent, insensitive and arrogant practices at the expense of the economically weak by an economically strong corporation."

WellCare, which is Florida's largest Medicaid plan operator, has acknowledged that it overcharged Florida and Illinois health programs by about $46.5 million.

In the aftermath of a federal raid, WellCare has taken several steps to clean house and put the scandal behind it.

William R. Levesque can be reached at levesque@tampabay.com or (813) 226-3432.

Settlement talks for WellCare whistle-blowers under way 12/05/11 [Last modified: Monday, December 5, 2011 10:10pm]
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