Thursday, July 08, 2010


Greenacres Democrat questions why Florida balks at corporate misdeeds, while targeting senior citizens for fraud

TALLAHASSEE – State Senator Dave Aronberg (D-Greenacres) on Thursday renewed his call on Attorney General Bill McCollum to intervene in a pending settlement with healthcare giant WellCare, and move to collect up to $1 billion in repayment and damages as a result of alleged Medicaid and Medicare fraud.

He also asked for clarification on an announcement by McCollum and Agency for Healthcare Administration head Tom Arnold to scrutinize over 3 million Florida senior citizens for possible Medicaid and Medicare fraudulent behavior.

“There has been no response since I raised the caution flags on a pending federal settlement with WellCare that could cost our state close to $1 billion," said Sen. Aronberg. "Instead, the priority is to file for a controversial waiver that would focus the AG's enforcement glare on Florida's seniors 65 years and older as potential crooks. Meanwhile, the state seems prepared to walk away from a billion dollars of Wellcare settlement money. The priorities appear to be backwards."

Aronberg's concerns stem from a letter he sent last week to the Attorney General asking him to intervene in a $137.5 million Medicaid fraud settlement reportedly struck by federal prosecutors and WellCare. The fraudulent overbillings allegedly committed by the company amount to between $400 million and $600 million. In addition, the state could be entitled to treble damages.

While the Senator continues to await a response to his request, the Attorney General and AHCA chief announced Wednesday that they were seeking a waiver from the federal government to expand their powers to investigate potential abuse. Noting the state’s “3.03 million seniors (age 65+),” the duo outlined their plans to include data mining for fraud and abuse by zeroing in on “population specific activities” that would “encompass statewide Medicaid activities.”

Ironically, in 2003, the AG’s Medicaid Fraud Control Unit was placed on probation by the U.S. Department of Health and Human Services for violation of the same federal law to which it is now seeking the waiver.

In addition, just two years ago, an audit by the Office of Program Policy Analysis and Government Accountability urged AHCA to implement advanced fraud detection systems, finding that while the agency had improved its oversight of managed care organizations, “it needs to take more steps to deter and detect corporate level abusive and fraudulent practices.”

“While bad apples can be found in any group, the state needs to first focus on plucking the ones already in sight,” said Sen. Aronberg. “While the waiver might be a good idea for future Medicaid fraud investigations, WellCare is here and now. It needs to be the immediate focus.”

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