In re: Wellcare Health Plans: Company That Was an Unindicted Co-Conspirator and Which Admitted to Being a Co-Conspirator to Underlying Fraud Was Not a Victim Under CVRA and MVRA

In re: Wellcare Health Plans, No. 14-12422-B, from MDFla (Petition for Writ of Mandamus)

Per curiam order by Circuit Judge Hull and Circuit Judge Jordan.

Summary: The petitioner sought a writ of mandamus declaring it to be a victim under the Crime Victims’ Rights Act, 18 U.S.C. § 3771, and the Mandatory Victims Restitution Act, 18 U.S.C. §3663A.  The petitioner had been charged in a criminal information charging it with conspiring through its former officers and employees to violate Florida healthcare programs.  The petitioner entered into a deferred prosecution agreement, whereby it agreed to stipulated facts stating that it knowingly and willfully conspired to execute a scheme and artifice to defraud Florida healthcare programs of $40 million dollars and agreed to pay $40 million in restitution and $40 million in civil forfeiture, as well as to fully cooperate with the ongoing government investigation.

A federal grand jury subsequently indicted the petitioner’s former CEO, CFO, and various vice presidents for healthcare fraud and making false statements.  The jury found several of these persons guilty of either healthcare fraud or making false statements.  Notably, the petitioner was named as an unindicted co-conspirator.

Subsequently, the petitioner sought restitution from three of the defendants who were found guilty of healthcare fraud.  When the district court denied the petitioner’s motion to be labeled a victim for purposes of restitution, the petitioner filed this petition for mandamus.

First, the panel concluded that a writ of mandamus under the CVRA was subject to review under general appellate mandamus principles, meaning that it was subject to only a clear abuse of discretion standard.
 

Second, the panel examined whether the district court abused its discretion.  The CVRA explicitly provides that a person accused of the crime may not obtain any form of relief as a victim, whether restitution or otherwise.  The panel concluded that the petitioner was not a victim under either the CVRA or the MVRA because it admitted that it was a co-conspirator in the underlying fraudulent conduct.

The panel accordingly found that the district court did not abuse its discretion and denied the petition for a writ of mandamus.

Note: Pursuant to 18 U.S.C. § 1771(d)(3), a court of appeals must take up and decide an application for a writ of mandamus within 72 hours after the petition has been filed.  Thus, there is a quick turnaround time for such petitions and they may be decided by a single circuit judge, although the Eleventh Circuit typically has a panel of two judges assigned.