The Justice Department raised concerns about Centene’s handling of prescription drug and pharmacy benefit services cost reporting to the state’s Medicaid program, according to a Jan. 6 news release.
Between January 2016 and December 2021, the state anticipates the payer’s inaccurate reporting resulted in $2.4 million in losses for the state. The state used a formula from Centene used in similar investigations and its own projections to determine the settlement amount of $21 million.
The settlement dismisses the need for further investigation, review or potential litigation, according to the news release.
“This settlement represents a significant recovery for New Hampshire taxpayers that adequately compensates the state for the financial harm it has suffered,” said New Hampshire Attorney General John Formella. “We appreciate Centene’s willingness to engage with the state to resolve this matter quickly and fairly. While this settlement is significant, we will not fall victim to complacency and will continue to take action to protect the financial interests of the State and its taxpayers.”
The state’s investigation came after watching similar issues arise between Centene and other states’ Medicaid programs, according to the Justice Department. Centene has previously settled similar allegations in Arkansas, Illinois, Ohio, Mississippi and Kansas.
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