WellCare Looks For the Silver Lining In Its Disastrous Year

WellCare Health Plans doesn’t have a lot to celebrate this year, but that doesn’t mean it can’t still try to see the bright side. Just two weeks ago, the mid-sized health-insurance company put out a glowing press release patting itself on the back for “providing an outstanding customer service experience.” WellCare crowed that it met “rigorous standards” for certification by J.D. Power and Associates, the outfit best known for its automobile-quality ratings.

Which all sounds great, at least until you realize this “certification” only reflects on the supposed quality of WellCare’s call center — the vast assemblage of operators who field more than 10 million calls from WellCare members every year. Apparently WellCare’s representatives rated within the top 20 percent of customer-service scores based on “courtesy, knowledge, concern for the customer,” and similar factors. Oddly enough, the insurer’s benefit packages, payment of claims, selection of doctors and concern for the health of its members didn’t come into play in this particular survey.

WellCare, of course, has every reason to look for silver linings wherever it can. (In October, for instance, WellCare proudly announced it had received the “Senior Choice Gold Award” for the design and “value” of its Medicare Advantage plans — along with 31 other health plans, that is.) The company, of course, was famously raided by the FBI in October 2007 regarding an alleged Medicaid reimbursement problem. For BNET readers, here are a number of iWellCare’s most notable moments from its annus horribilis.

• Jan. 25: WellCare Chairman and CEO Todd Farha resigns, along with the company’s CFO and general counsel.
• April 7: WellCare announces that it accidentally exposed the personal information of many of its members on the Internet.
• May 22: WellCare lays off five percent of its workforce.
• July 21: WellCare says it will restate three years of earnings after it improperly accounted for Medicaid expenses in Florida and Illinois.
• Oct. 6: The Justice Department announces that a formerWellCare employee plead guilty to conspiracy to defraud the Florida Medicaid program of more than $20 million.
• Nov. 13: WellCare says it’s under investigation by so many state and federal agencies that it can’t file its quarterly earnings reports.