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WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug plans for members across the United States. WellCare began operations in 1985 and has its headquarters in Tampa, Florida.
The announcement resulted in an investigation by regulators from the Federal and California governments. [94] Anthem Blue Cross gained worldwide media attention and became a poster child for the problem of rising cost of health care in the U.S. [ 94 ] The rate increase came one year after Anthem had raised rates 68% on individual policy holders.
In 2002, he sold majority share in the WellCare Management Group, at which point WellCare Management was providing services to over 400,000 members. In 2007, Patel started a new insurance holding company called America's 1st Choice Holdings of Florida and acquired two Tampa Bay based Medicare Advantage Health Plans, Freedom Health and Optimum ...
A case of Medicaid fraud was carried out in 2010 by an Armenian-American organized crime group called the Mirzoyan–Terdjanian organization. [1] [2] The scam involved a crime syndicate which created 118 fake clinics in 25 states and used stolen medical license numbers of real doctors and matched them to legitimate Medicare patients whose names and billing information were also stolen.
Office of Investigations (OI). OI conducts criminal, civil, and administrative investigations of fraud and misconduct related to HHS programs, operations, and beneficiaries. With investigators working in almost every State, OI coordinates with DOJ and other Federal, State, and local law enforcement authorities.
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Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...
The Serious Fraud Office was established by the government in 1987 to improve the investigation and prosecution of serious and complex fraud cases. [58] The City of London Police runs an Insurance Fraud Enforcement Department, that specializes in tracking criminals who knowingly commit insurance fraud. [60]