United States v. Clay, No. 14-12373 (11th Cir. 2016)Annotate this Case
Defendants Farha, Behrens, Kale, and Clay appeal their convictions for charges related to Medicaid fraud on multiple grounds. Defendants were all high-level executives of WellCare or one of its Florida subsidiaries, Staywell and HealthEase. At trial, the government proved that together defendants participated in a fraudulent scheme to file false Medicaid expense reports that misrepresented and overstated the amounts Staywell and HealthEase spent on medical services for Medicaid patients, specifically outpatient behavioral health care services. The court concluded that the evidence was sufficient to convict Farha, Behrens, and Kale for health care fraud; there was sufficient evidence to convict Behrens for making false representations to AHCA; and there was sufficient evidence to convict Clay for making false statements to federal agents. The court rejected Farha, Behrens, and Kale's challenge to the jury instructions with regard to their fraud convictions. Finally, the court rejected defendants' claims of evidentiary error. Accordingly, the court affirmed the convictions.