Centene says Ohio lawsuit against its PBM can be 'easily explained away'

Centene has filed a response to an Ohio lawsuit claiming its subsidiary, Buckeye Health Plan, used a web of subcontractors to misrepresent pharmacy costs, leading to millions of dollars in overpayments by the state's Medicaid department, The Columbus Dispatch reported. 

In an April 2 filing, Centene said the state's claims are "easily explained away once the facts about Buckeye's reporting and billing to the Ohio Department of Medicaid are understood." 

"These outside counsel failed to recognize the regulatory history and precedents of Ohio's Medicaid system and violated the state's contractual requirements to first provide 'timely written notification' of any alleged violation and 'to make every reasonable effort to resolve the dispute,'" the filing said, according to the Dispatch

Ohio Attorney General Dave Yost said the lawsuit was filed under seal because of a nondisclosure agreement, but Centene urged the state to unseal the lawsuit, saying: "Lifting the seal is necessary to avoid any implication that defendants are hiding anything," the Dispatch reported. 

Mr. Yost said he'd be happy to unseal the lawsuit, "if Centene is not going to hold our feet to the fire on the NDA," according to the Dispatch

Read the full article here

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