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State settles lawsuit with Medicaid HMO

The Tampa-based HMO WellCare has agreed to a $137 million payout to settle a lawsuit that accuses the company of committing Medicare and Medicaid fraud. Lynn Hatter reports the settlement marks an agreement involving nine states including Florida, and the federal government.

WellCare contracts with governments to run Medicaid and Medicare managed care plans. It’s accused of “cherry-picking” enrollees to maximize profits, over-charging for cost of care, and not returning money when the state of Florida made payment errors—something it was required to do in its contract. Florida Attorney General Spokeswoman Jenn Meale says the state will get $54 million from the settlement.

 “The bulk of the money Florida will receive will go to the Agency for Healthcare Administration.”

That’s the agency that oversees the state’s Medicaid program.  WellCare settled its criminal case two years ago. It was accused of $40 million  worth of Florida Medicaid fraud. 

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Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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