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Hold-Out Whistleblower in False Claims Act Suit Against WellCare Agrees to Settlement

In late February, the primary whistleblower in a False Claims Act suit against WellCare Health Plans of Tampa, Florida finally conceded to settle. For 2.4 million Medicare and Medicaid recipients, WellCare provides managed-care health plans.

For months, Sean Hellein objected to the government’s $137.5 million settlement as being too low. Now the whistleblower has consented to a compromise that gives him a bonus not shared by the other three whistleblowers in the suit; Hellein also will receive a portion of an earlier settlement that WellCare paid to end criminal charges.

It’s not difficult to understand why Hellein feels entitled to a larger share of the government’s recovery.  The former WellCare executive took the risk of wearing wiretaps for the FBI during company meetings. When he was a senior financial analyst with the company in 2006, Hellein made secret recordings of discussions in which WellCare executives plotted out schemes for double-billing Medicare and Medicaid for patient services.

As a result of Hellein’s bravery, the FBI was able to obtain the evidence it needed to conduct a raid of  WellCare’s headquarters in Tampa in October of 2007.

Since then, WellCare has been beset with legal troubles. In 2009, the company paid an $80 million fine to settle criminal charges by the federal government. In 2010, WellCare negotiated a $200 million settlement to end a class action suit by shareholders. And now, the company is poised to resolve the civil False Claims Act suit against it.

The federal False Claims Act allows private individuals to sue corporations that defraud the federal government. A whistleblower who files such a claim is called a “relator.” As an incentive to encourage people to take this often difficult step, the qui tam provisions of the statute allow the whistleblower to share in a portion of the government’s recovery.

The four whistleblowers in the WellCare case will share in up to 25 percent of the $137.5 million civil settlement and Hellein will take home a part of the criminal settlement as well.

Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in health care fraud cases. Contact us to learn more about our practice and how we can assist.

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