Medicaid HMO Carrier Overcharged Illinois $1M

Wellcare Health Plans, a Tampa-Fla.-based company that manages Illinois' largest Medicaid HMO plan, revealed that it had overbilled the state by around $1 million from July 2006-June 2009, according to a report in The Chicago Tribune.


According to Wellcare, the error was a result of a miscalculation of "capitation expense," resulting in the company overcharging 0.2 percent on its premium to the state. The company will credit the overpayment, according to the report.

Illinois Governor Pat Quinn is considering requirements that would move more of the state's 1.9 million Medicaid recipients into HMOs to lessen the impact of the state's $13 billion budget deficit, according to the report.

Read the Tribune's report on Illinois' Medicaid overpayment.

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