WellCare faces monitoring, fine to resolve charge

Health insurer WellCare Health Plans Inc. said Tuesday it will pay $80 million and agree to independent monitoring to resolve charges it committed health care fraud in Florida.

The company has been under scrutiny since 2007, when the FBI and Florida's attorney general's Medicaid Fraud Control Unit raided the Tampa, Fla.-based company's offices. In February, the company suspended marketing and enrollment for its Medicare health plans because of regulatory sanctions. The plans are part of its core business.

The current deal involves agreeing to a deferred prosecution agreement where the U.S. Attorney charges the company with conspiracy to commit health care fraud against the Florida Medicaid and Healthy Kids programs, through certain contracts.

The deal requires WellCare to retain an independent monitor, selected by the U.S. Attorney, for a period of 18 months. The actual term of the deferred prosecution agreement is 36 months, but after a period of 18 months, the U.S. Attorney could agree to reduce it to 24 months.

The company has already paid $35.2 million and will pay $25 million within five business days of entry into the agreement. The remaining $19.8 million will be paid no later than Dec. 31.

Shares of the company added $2.91, or 18.6 percent, to $18.53 in midday trading.