In Re Wellcare Management Group, Inc. Securities Litigation
MEMORANDUM-DECISION & ORDER
I. BACKGROUND
Before the Court are two motions to dismiss the plaintiffs’
1
Amended Complaint pursuant to
It is the Wellcare defendants’ position that the plaintiffs’ Amended Complaint fails to plead scienter as required under § 10(b) of the Securities and Exchange Act of 1934. In addition, and assuming that the Court agrees with the Welleare defendants’ first position, the Wellcare defendants contends that the plaintiffs’ § 20(e) claim, alleging controlling person liability, should be dismissed.
It is the defendant Deloitte & Touche’s position that the plaintiffs have failed to allege a viable § 10(b) claim.
The Court now turns to the factual allegations made by the plaintiffs against each category of defendant.
A. Wellcare Defendants
The class period is March 28,1994 through May 14,1996.
The defendant Wellcare is a managed health care holding company. Wellcare’s revenue consisted largely of premiums earned by WCNY, a wholly owned subsidiary health maintenance organization. One of Wellcare’s largest expenses was the medical expenses incurred by WCNY. These “medical expenses” include hospital charges, physician fees, and related health care costs, and estimates of benefit claims incurred but not yet reported. This case relates to alleged improper accounting and reporting activities by the defendants aimed at deceiving investors by artificially inflating reported revenues and deflating expenses.
The defendant Edward Ullman is Well-care’s founder, and served as Wellcare’s Chairman, President, and Chief Executive Officer from its inception in 1983 until April 30,1996. Ullman remained as a director and President of Wellcare until September 10, 1996, when he was replaced as President. Ullman signed each of the company’s Form 10-K annual reports and Form 10-Q reports filed with the SEC during the class period.
Ullman was employed under a four-year agreement which provided for an annual bonus of 2% of Welleare’s uncapped pretax profits for 1994, and 2% of Wellcare’s net profits up to a maximum of $200,000 per year thereafter. Ullman was also entitled to receive an additional bonus if so determined by the Board of Directors. Under Ullman’s employment contract, he was entitled to receive options to purchase shares of Welleare common stock on January 1 of each year during the term of his employment and stock appreciation rights that vested 25% each calendar year.
The defendant Marystephanie Corsones joined Wellcare, from Coopers & Lybrand, as Finance Directоr in July 1993, and since May 1994 has served as Wellcare’s Chief Financial Officer and Vice President of Finance. Corsones has been a member of Wellcare’s Board of Directors and Audit committee since November 1994. Corsones signed each of Wellcare’s 10-K and 10-Q forms beginning in the second quarter of 1994.
The Amended Complaint alleges that the price of Wellcare stock was artificially inflated as a result of the Wellcare defendants’ knowing or reckless conduct which caused Welleare to report inflated revenues, lower
To sustain the price of its stock, Wellcare had to demonstrate that it was a growing company. This allegedly led to a series of actions by the Wellcare defendants designed to show higher earnings and reduced expenses.
The following transactions are alleged by the plaintiffs as the basis for their claims:
Purchase of Mid-Hudson
Mid-Hudson Health Plan, Inc. (“Mid-Hudson”) was a not-for-profit HMO that had been managed by Wellcare since it was established in 1984. The plaintiffs allege that Mid-Hudson was no more than a shell corporation, dependent on Wellcare for its existence. The alleged wrongdoing by the Well-care defendаnts occurred in connection with the acquisition of Mid-Hudson.
When Wellcare acquired Mid-Hudson, it accounted for the acquisition as a purchase in Welleare’s year-end 1993 financial statements. The plaintiffs contend that Mid-Hudson was always a “special purpose entity,” and as such, the acquisition should have been treated as a consolidation, thereby merging the financial statements for each entity. The ultimate result of treating the acquisition as a purchase rather than a consolidation was to inflate the net income of Wellcare from $2,830 million to $4,648 million, and earnings per share from $0.56 to $0.93. In addition, Wellcare recognized $6,549 million of “Goodwill,” i.e., the difference between the purchase price of $2.44 million and Mid-Hudson’s negative net worth of $4 million. Thus, Welleare’s assets and retained earnings were overstated by $4,109 million. The plaintiffs further allege that such accounting procedures do not comply with GAAP.
1994 Transactions
Again with the aim of showing increased net income and reduced expenses, the plaintiffs allege that Wellcare engaged in a series of improper transactions in 1994. In brief, on April 5, 1994, Ullman directed the payment by Catskill Medical of over $100,000 to doctors to whom Wellcare owed money, despite the fact that some of the debts predated the incorporation of Catskill Medical. On May 13, 1994, Wellcare received a $250,000 payment from Catskill Medical which was accounted for as a deficit payment, thereby reducing the amount of medical expenses incurred by Wellcare, despite the fact that there is no record of Catskill owing Wellcare such an amount. In late June 1994, 40 cheeks totaling $1,500,000 were received by Wellcare. However, the true source of these funds was two bank loans personally guaranteed by Ullman. In 1994, a total of $2.7 million was transmitted by companies such as Catskill Medical to Wellcare. Such funds were accounted for as deficits, but actually came frоm bank loans guaranteed by Ullman. The plaintiffs allege that medical expenses were understated by Wellcare in 1994 by $4.7 million, despite the fact that such expenses were actually rising.
Sale of Wellcare Medical Management to PrimErgy, Inc.
The plaintiffs also allege that in 1995, in an effort to create the illusion of profitability, Wellcare sold Wellcare Medical, Management, a wholly owned medical management subsidiary, to PrimErgy, Inc., for $570,000 cash and a note for $5.13 million. However, PrimErgy, Inc. allegedly was formed for the sole purpose of acquiring Wellcare Medical Management. In addition, just prior to the sale, Wellcare allegedly transferred $5.1 million to Wellcare Medical Management. The significance of this sale was to show the note as an asset on Wellcare’s books, despite the dubious value of the note. Apparently, Well-care Medical Management was virtually worthless absent the cash transfer from Wellcare. Wellcare even retained an option to repurchase Wellcare Medical Management in five years. Finally, it seems that Ullman personally guaranteed a $3 million line of credit to sustain the thinly capitalized PrimErgy. shortly after the sale.
Sale of Bienestar Trademark
Also in 1995, and in an effort to inflate revenue for that year, Wellcare recognized
A March 16, 1996 Barron’s article first publicized these transactions. The price of Wellcare stock immediately fell 12%. Within two weeks, despite an initial rebuttal to the article, Wellcare announced that it believed “a restatement will be required.”
Wellcare then submitted a Form 12b-25 Notification of Late Filing with the SEC seeking two weeks additional time for the completion of an audit to permit further review and investigation as a result of thе Barron’s article. The two weeks became two months.
Ullman was removed as Chairman and Chief Executive Officer, NASDAQ notified Wellcare that it was delisting the company’s common stock, effective May 13, 1996, and the price of Wellcare stock continued to fall.
On May 14, 1996, Wellcare restated its 1994 and 1995 financial statements. The results for 1994 were: earnings per share reduced by nearly 50%; medical loss ratio increased from 77.8% to 81.7%, which is alleged to be significant; and the company admitted that it improperly recorded as deficit payments $4.7 million in payments made from physician groups via bank loans guaranteed by Ullman.
The results for 1995 were: earnings per share reduced by over 75%; the company admitted that it had not received any fees from the sale of the Bienestar trademark; and the company stated that it would show a reserve for the $5.1 million note from the sale of Wellcare Medical Management by reason of its uncollectibility.
B. Defendant Deloitte & Touche
The plaintiffs also allege a § 10(b) claim against their auditors, Deloitte & Touche. The basis for this claim is alleged violations of generally accepted auditing standards (“GAAS”), and its allegedly reckless conduct in relation to the accounting of the 1994 transactions and the Mid-Hudson acquisition, described above. It is the contention of the plaintiffs that Deloitte & Touche was aware of facts that should have prompted it to conduct further investigation, and/or that Deloitte & Touche faced enough “red flags” to put it on notice of improper accounting practices by Wellcare. Deloitte & Touche claim that, at best, the plaintiffs have alleged a claim for negligence.
The Court now turns to the issues presented.
II. DISCUSSION
A. Standard for a Motion to Dismiss
On a dismissal motion for failure to state a claim pursuant to
When fraud is asserted, as in the instant case, the Court also must view the Amended Complaint in light of
It is with these legal standards in mind that the Court turns to the issues presented.
B. Sufficiency of Amended Complaint as to Scienter
The plaintiffs allege claims pursuant to Sections 10(b), or more specifically Rule 10b-5 of the regulations promulgated thereunder, and 20(a) of the Securities Exchange Act.
It shall be unlawful for any person, ... (a) To employ any device, scheme, or artifice to defraud, (b) To make any untrue statement of a material fact or to omit to state a material fact necessary in order to make the statements made, in the light of the circumstances under which they were made, not misleading, or (c) To engage in any act, practice, or course of business which operates or would operate as a fraud or deceit upon any person, in connection with the purchase or sale of any security.
Every person who, directly or indirectly, controls any person liable under any provision of this chapter or of any rule or regulation thereunder shall also be liable jointly and severally with and to the same extent as such controlled person to any person to whom such controlled person is liable, unless the controlling person acted in good faith and did not directly or indirectly induce the act or acts constituting the violation or cause of action.
Thus, to make out a claim for securities fraud, the plaintiffs must allege that “in connection with the purchase or sale of securities, the defendant, acting with scienter, made a false material representation or omitted to disclose material information and that plaintiffs’ reliance on defendant’s action caused [plaintiffs] injury.”
Acito v. IMCERA Group, Inc.,
It is as to the sufficiency of the Amended Complaint with respect to scienter that the parties disagree in this case. The Court first notes that, after a review of the case law relating to this issue, the law relating to the sufficiency of a Complaint as to scienter is murky at best. Nevertheless, the Court has attempted to reconcile the relaxed pleading requirements of
As stated above, and in accordance with
1. Defendants Wellcare, Ullman, and Corsones
The plaintiffs argue that their Amended Complaint sufficiently alleges, on the part of the defendants Wellcare, Ullman, and Corsones, facts establishing (1) that each defendant had the opportunity and motive to misstate Wellcare’s financial status during 1993, 1994, and 1995, and (2) conscious or reckless behavior in relation to the alleged
As to the alleged opportunity and motive to misstate Wellcare’s financial status during 1993,1994, and 1995, the plaintiffs claim that the Amended Complaint sets forth sufficient facts to show that the defendants Ullman and Corsones had personal incentives to misstate Welleare’s financial condition in the form of incentive compensation plans tied to earnings, and that Ullman was the controlling shareholder of the corporation.
As to the allegations of conscious or reckless behavior, the plaintiff claim that the Amended Complaint sets forth (1) that the defendants prompted a series of “unusual transaction” in 1994 that improperly treated payments as assets rather than expenses on Wellcare’s profit and loss statements, and understated Wellcare’s liabilities to entities that made payments on Wellcare’s bеhalf, (2) Ullman and Corsones executed a “purchase” of Mid-Hudson in 1993, and thereby created an asset on Wellcare’s balance sheet when Mid-Hudson was actually a consolidated part of Wellcare all along, and thus, the alleged “purchase” should have been expensed in the 1994 Wellcare financial statements; (3) that the “sale” of Wellcare Medical Management to Primergy enabled Wellcare to recognize inflated income was undercapitalized for a number of reasons, including the recording of income from foreign licensing fees subsequently reversed as part of the restatement and the failure tо establish certain reserve accounts.
The defendants claim that the plaintiffs’ “allegations” are conclusory, rest on claims contained in a sensational Barron’s article and on allegations of violations of GAAP and GAAS, misstate the true nature of certain transactions and the knowledge that the defendants had at the time the transactions occurred, and are insufficient to withstand a motion to dismiss under Second Circuit law. The Court will address these issues seriatim,
i. Motive and Opportunity
In this Circuit,- motive and opportunity are defined as the following: “Motive would entail concrete benefits that could be realized by one or more of the false statements and wrongful nondisclosures alleged. Opportunity would entail the means and likely prospect of achieving concrete benefits by the means alleged.”
Shields v. Citytrust Bancorp, Inc.,
The Amended Complaint alleges that Ullman had a personal motive to commit the fraudulent acts alleged in that his employment contract with Wellcare provided for an annual bonus of 2% of Wellcare’s uncapped pretax profits for 1994 and 2% of Wellcare’s net profits up to a maximum of $200,000. In addition, it is alleged that Ullman was Well-care’s largest single shareholder, and thus, would benefit from an inflated stock price. Finally, Ullman was entitled to 15,000 shares of stock appreciation rights that vested 25% аnnually.
As to the defendant Corsones, the Amended Complaint alleges that she was entitled to an annual bonus of 1% of Wellcare’s net profit up to $100,000, and thus, had a motive to defraud investors.
The Court first notes that this Circuit has held
allegation[s] that defendants were motivated to defraud [ ] because an inflated stock price would increase their compensation is without merit. If scienter could be pleaded on that basis alone, virtually every company in the United States that experiences a downturn in stock price could be forced to defend securities fraud actions. ‘[I]neentive compensation can hardly be the basis on which an allegation of fraud is predicated.’
Acito,
In cases where courts have found a strong inference of an intent to deceive on the basis of motive, the defendant generally has had to hаve actually realized a benefit, not merely had the potential for a benefit.
See, e.g., Turkish v. Kasenetz,
There is no question that the Amended Complaint sufficiently alleges that the defendants had an opportunity to commit fraud. As stated in the Amended Complaint, the individual defendants were the president and chief financial officer of Welleare. Ullman signed each 10-K statement, was familiar with the financial condition of Welleare, and allegedly orchestrated each fraudulent transaction. Corsones was ultimately responsible for the creation of the financial stаtements themselves. As an experienced financial officer and accountant, Corsones should have known, according to the Amended Complaint, that Welleare was engaged in fraud. The alleged misstatements generally relate to the amount of medical expense for a given year, revenue, and other component of the financial statements for Welleare. Thus, it is clear to the Court that the Amended Complaint states sufficient facts to show opportunity to commit fraud.
See, e.g., Chill v. General Elec. Co.,
Ullman and Corsones allegedly profited from the artificially inflated stock price of Welleare, and were in position that enabled them to effectuate that result. Thus, on the basis of the forgoing discussion, the defendants’ Ullman and Corsones motion to dismiss should be denied.
ii. Conscious or Reckless Behavior
Having found that the Complaint sufficiently alleges motive and opportunity, the Court need not discuss whether the Complaint sufficiently alleges facts that constitute strong circumstantial evidence of conscious misbehavior or recklessness.
See Time Warner,
Although the Second Circuit has maintained that recklessness is a form of scienter in “appropriate circumstances,”
Rolf v. Blyth, Eastman Dillon & Co., Inc.,
The Amended Complaint allegеs that the defendants Ullman and Corsones had knowledge of, condoned, and/or encouraged (1) the deliberate overstatement of earnings by a number of means, (2) demands for checks from medical practices whose doctors were not contracted with Wellcare, (3) the demand for and receipt of checks from doctors allegedly for nonexistent deficits, (4) the misstatement of assets such as “other reeeivablesnet,” (5) the improper treatment of the “acquisition” of Mid-Hudson, and (6) the failure to take a reserve in connection with the foreign licensing of the “Bienestar” trademark. Assuming, as the Court must, that the allegations rеlating to these actions is true, the Court finds that the plaintiffs have alleged facts tending to show negligence that is tantamount to intent.
See In re Leslie Fay Companies Inc.,
For the reasons stated herein, the Court finds that the plaintiffs have pleaded scienter sufficiently to withstand the defendant’s Ullman and Corsones motion to dismiss.
C. Motion to Dismiss Controlling Persons Claim
To establish a claim under § 20(a), a plaintiff must allege (1) a primary violation, (2) scienter, and (3) control of the primary violator by the defendant.
Robbins v. Moore Medical Corp.,
D. Defendant Deloitte & Touche
The Second Circuit has repeatedly held that for § 10(b) violations, an allegation of recklessness is sufficient.
See, e.g., Sirota v. Solitron Devices Inc.,
The plaintiffs make a number of allegations in support of their claims against Deloitte & Touche. First, the Amended Complaint alleges a number of violations of generally accepted auditing standards (“GAAS”). However, it is well settled that alleging that an auditor violated GAAS is insufficient, standing alone, to withstand a motion to dismiss.
See In re Frank B. Hall & Co., Inc., Sec. Litig.,
As to each of these transactions, Deloitte & Touche claims that the Amended Complaint fails to allege that Deloitte & Touche attempted to hide or conceal any relevant facts. In addition, Deloitte & Touche claims that the Amended Complaint fails to allege that it manipulated or deceived anything or anyone as required by § 10(b). Deloitte & Touche point out that the Amended Complaint concedes that it publicly disclosed all pertinent information in Deloitte & Touche’s audit opinion. In fact, Deloitte & Touche claim that all of the detail in the Amended Complaint about how different the Mid-Hudson transaction would have looked under a consolidation, as compared to a purchase, came from documents publicly disseminated after the 1993 audit it performed. As to the alleged improper reporting with respect to the $2.7 million in loans, Deloitte & Touche claim that no more than the failure to investigate deeply enough, i.e., negligence, is alleged. Again, no information was withheld, explained away, or concealed by Deloitte & Touche.
The Court first reiterates that in this ease’s present posture, the Court must accept as true all allegations in the Amended Complaint, and draw all reasonable inferences in favor of the plaintiffs.
See In Re Leslie Fay,
§ 78j . Manipulative and deceptive devices It shall be unlawful for any person, directly or indirectly, by the use of any means or instrumentality of interstate commerce or of the mails, or of any facility of any national securities exchange— b) To use or employ, in connection with the purchase or sale of any security registered on a national securities exchange or any security not so registered, any manipulative or deceptive device or contrivance in contravention of such rules and regulations as the Commission may prescribe as necessary or appropriate in the public interest or for the protection of investors.
Moreover, the Exchange Act has been amended to include the following language: (2) Required state of mind
In any private action arising under this chapter in which the plaintiff may recover money damages only on proof that the defendant acted with a particular state of mind, the complaint shall, with respect to each act or omission alleged to violate this chapter, state with particularity facts giving rise to a strong inference that the defendant acted with the required state of mind.
It is clear that the Amended Complaint alleges that the defendаnt auditor violated industry standards. In addition, the Amended Complaint alleges that Deloitte & Touche knew or should have been aware of certain actions by Wellcare that would have in the long run decreased the reported income for 1993 and 1994, and thereby decreased the stock price per share. It is also clear from the Amended Complaint that no specific information was hidden from the public by Deloitte & Touche. In fact, Deloitte &
After considering the allegations in the Amended Complaint, the Court concludes that the plaintiffs have failed to make out a viable § 10(b) claim against Deloitte & Touche. At best, the plaintiffs have alleged violations of GAAS and negligence. This is insufficient as a matter of law.
See Decker,
Although there may be more specific factual allegations in the instant Amended Complаint, the Court finds that the plaintiffs have failed to allege facts that would approximate actual intent to manipulate or deceive. The facts alleged do not raise a strong inference of recklessness, as that term has been defined in Circuit precedent. See
III. CONCLUSION
For the reasons stated herein, the motion to dismiss the Amended Complaint brought by the defendants Ullman and Corsones is hereby DENIED, and the motion to dismiss the Amended Complaint brought by the defendant Deloitte & Touche is hereby GRANTED, and the Court hereby ORDERS that the claims asserted against the defendant Deloitte & Touche be dismissed, with prejudice.
IT IS SO ORDERED.
Notes
. The instant case is a class action.
. Governing private class action securities litigation.
. The elements of fraud are not contested. At issue is the sufficiency of the Complaint with respect to scienter.
. The Court need not reach the issue of whether the Amended Complaint sufficiently pleads that the work performed by Deloitte & Touche was "in connection with the purchase or sale of any security” as required under § 10(b).