Centene to settle drug overbilling allegations for $143M

Centene reached no-fault agreements to resolve allegations that the health insurer's pharmacy benefits manager misrepresented pharmacy costs for Medicaid beneficiaries, according to a June 14 news release.

The insurer faced the allegations in Ohio and Mississippi, with both states accusing Centene of using subcontractors to misrepresent pharmacy costs. The states said the alleged misrepresentation resulted in millions of dollars in overpayments by the states' Medicaid departments. 

Centene agreed to pay Ohio $88 million to settle the allegations and Mississippi $55 million. 

"We respect the deep and critically important relationships we have with our state partners," Brent Layton, Centene's president of health plans, markets and products, said in the news release. "These agreements reflect the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent. Importantly, putting these issues behind us allows us to continue our relentless focus on delivering high-quality outcomes to our members."

Centene has set aside $1.1 billion to resolve similar allegations in other states. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars