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Whistleblowers Like This One Needed to Clean Up South Florida Health-Care Industry

South Florida is arguably the health-care fraud capital of the U.S. There's so much fraud, it's hard to blame the crook who reasons that stealing merely a million dollars won't put him on the radar of federal law enforcement. Health-care fraud is the fastest way to Easy Street. Just ask the next guy you see driving a Ferrari.

But it's a shame that more of our local health-care greedheads don't know that you can also get rich by busting health-care fraud. Just ask Sean Hellein, who stands to become a multimillionaire following his takedown of Wellcare.

Hellein was profiled in today's edition of the St. Petersburg Times. Prospective local health-care whistleblowers are advised to skip past the part about how going undercover was nerve-wracking and exhausting and nearly destroyed his marriage. (Actual fraud has the same hazards, doesn't it?)

The designer of a software program that aided WellCare's fraud, Hellein was told by FBI agents to simply keep doing his job -- fraud or not.

Hellein said if anyone suspected his covert activity, they never confronted him about it. Instead, his work was so valued his bosses gave him $300,000 worth of stock. FBI agents told him to keep it.
So he gets rich being an accomplice to fraud, but since he's also helping the feds build a case, he's not in danger of being criminally charged. Rather, he gets the chance to multiply his winnings:
The law allows whistle-blowers to share in up to 25 percent of any settlement. At least two other WellCare employees filed whistle-blower claims against the company, though Hellein was the first and the most deeply involved in the investigation. The Justice Department has tentatively agreed to settle these claims with WellCare for $137.5 million.
Pretty good score, isn't it? For Broward folks considering a career in whistle-blowing, this is rich hunting ground. The North Broward Hospital District is currently conducting an internal investigation prompted by concerns that it was operating in violation of federal anti-fraud statutes. The South Broward Hospital District is also vulnerable, judging by its inclusion in Hellein's whistleblower complaint, where he alleges that the public health care giant helped WellCare hide millions from Medicaid.

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Thomas Francis

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