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Federal Health Care Programs

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One of the major enforcement sagas in managed care came to a head on May 19th, when Todd S. Farha, former chief executive officer (CEO) for WellCare was sentenced to serve 36 months in prison for defrauding the Florida Medicaid program. WellCare operates health maintenance organizations (HMOs) in several states providing services through government-sponsored health care benefit programs like Medicaid. They provide managed health care services  for approximately 2.6 million Medicare and Medicaid beneficiaries, nationwide, and have been plagued with a series of investigations dating back to a Federal Bureau of Investigation (FBI) raid in 2007 that led to the indictment of five former executives. All five of them have now been convicted.

This article was published in the June 1, 2014 edition of Managed Care Outlook. Reprinted with permission.
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