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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 California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.
The United States District Court for the Southern District of California (in case citations, S.D. Cal.) is a federal court in the Ninth Circuit (except for patent claims and claims against the U.S. government under the Tucker Act, which are appealed to the Federal Circuit).
In 2012, James Hoyer represented one of four whistleblowers in a qui tam case against WellCare Health Plans, Inc that resulted in a $137.5 million settlement. [13] The lawsuits alleged a number of schemes to submit false claims to Medicare and various Medicaid programs.
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The act provides immunity to the State of California and its related entities from being sued. The law immunizes public employees from liability for “instituting or prosecuting any judicial or administrative proceeding” within the scope of their employment, “even if” the employees act “maliciously and without probable cause.” (Cal. Gov. Code, § 821.6)
Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates.
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.