The WellCare Investigation Saga Is Coming to a Close

Richard P. Kusserow | September 2014

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.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.