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Case Detail


United States v. Clay
On September 12, 2016, WLF encouraged the U.S. Court of Appeals for the Eleventh Circuit to grant Appellant’s petition for rehearing en banc in the case of U.S. v. Clay. WLF’s brief asks the appeals court to vacate the panel’s opinion and to reject the panel’s holding that deliberate indifference is an adequate substitute for knowledge as the required level of mens rea. Clay involves the indictment and conviction of C-suite executives at WellCare, a managed-care company that provides certain health care services under Florida’s Medicaid program. Seeing no contrary regulatory guidance, WellCare interpreted Florida’s so-called 80/20 statute such that it could lawfully set up a subsidiary to provide behavioral health care, a common practice for managed-care companies. Departing from usual administrative or civil remedies—Wellcare executives were convicted and sentenced to prison for making false claims and committing health care fraud.
Case Status:
Petition for rehearing en banc denied.
More Information and Downloads:
9/12/2016: Download the Brief

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