Centene

Health care giant pays Iowa $44M to settle fraud claims with Iowa

BY: - December 20, 2022

The nation’s largest Medicaid managed-care company last week agreed to pay Iowa $44.4 million to settle claims that it defrauded the state’s Medicaid system. That makes it the latest state to settle claims that were originally raised in Ohio in 2021. St. Louis-based Centene agreed to pay the money over claims that its subsidiary, Iowa […]

Another state settles Medicaid fraud allegations with Centene

BY: - December 12, 2022

Oregon on Tuesday became the latest state to settle fraud claims with a Medicaid managed-care giant. Litigation in such matters began in Ohio in 2021. St. Louis-based Centene, the largest Medicaid managed-care provider in the United States, agreed to pay Oregon $17 million, according to a statement from the state’s attorney general and its insurance […]

Tax-funded care provider in Ohio makes political donations — in Nevada

BY: - November 7, 2022

Medicaid managed-care provider Centene has already gotten in trouble in Ohio. Then on Friday came the news that its tax-funded Ohio subsidiary has been making political contributions 2,200 miles away in Nevada. Kaiser Health News reported that Centene’s Buckeye Health Plan and many other of its state-level Medicaid subsidiaries have each made $10,000 donations to […]

Pharmacy middleman agrees to pay Ohio Workers’ Comp $15M, attorney general says

BY: - October 27, 2022

OptumRx, a huge pharmacy middleman, has agreed to pay the Ohio Bureau of Workers Compensation $15 million to settle claims that it overbilled the system between 2015 and 2018, Attorney General Dave Yost announced Tuesday.

Centene agrees to pay Massachusetts $14 million over Medicaid prescription claims

BY: and - October 3, 2022

Massachusetts has become the latest state to settle with health insurance giant Centene Corp. over allegations that it overbilled the state’s Medicaid program for pharmacy services. St. Louis-based Centene, the nation’s largest Medicaid managed-care insurer, will pay $14.2 million, according to Massachusetts Attorney General Maura Healey. Before the Massachusetts agreement, Centene had settled with Ohio, […]

Centene settles with Texas over conduct first detected in Ohio

BY: - September 23, 2022

Centene settles with Texas over conduct first detected in Ohio.

11th state settles with Medicaid contractor over conduct first uncovered in Ohio

BY: - August 29, 2022

Centene, the largest Medicaid contractor in the United States, has settled with an 11th state over conduct that was initially detected in Ohio. On Aug. 24, a deal was announced between Washington Attorney General Bob Ferguson and St. Louis-based Centene to settle claims that Centene’s pharmacy benefit manager had overbilled the state’s Medicaid system, Reuters […]

Feds to probe drug rebates

BY: - June 20, 2022

The Federal Trade Commission last week announced what some observers believe could be a game-changer when it comes to the rising cost of prescription drugs. The agency — which is meant to protect fair competition — said it would look into the murky practice by which drugmakers grant rebates and other fees to insurer-owned pharmacy […]

Big Ohio care provider accused of putting profit over patients — in the UK

BY: - June 15, 2022

Health care giant Centene — which was accused of fraud in Ohio — is now in hot water in the United Kingdom. The BBC program “Panorama” this week published a documentary film and a news story saying that a Centene subsidiary there appeared to be skimping on costs and compromising care.  For its part, Centene’s […]

After years, pharmacy-middleman suit might finally come to trial

BY: - May 16, 2022

Since at least 2016, Ohio pharmacists have been accusing large companies acting as pharmacy middlemen of abusive practices, which they deny. And since 2019, the state has been accusing them as well, in the form of lawsuits. Now, after years of wrangling in court, some of that litigation might be headed to trial. The middlemen, […]

Government watchdog: Health care giants improperly denied Medicare benefits

BY: - May 6, 2022

The health care companies offering Medicare Advantage plans improperly denied services and payments at what might seem an alarming rate during a one-week test period in 2019, according to a government report released last week. The companies — many of which are also major players in the Ohio Medicaid system — improperly denied payment 18% […]

Ohio Medicaid won’t say if it considered federal oversight reports in massive procurement

BY: - March 22, 2022

The Ohio Department of Medicaid not only is refusing to release key oversight reports from its contractors, it’s refusing to say whether it even considered them last year as it undertook the largest public procurement in Ohio history.  As a consequence of that procurement, the company with the highest score on the federally required oversight […]