Centene

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 […]

Mississippi House votes to cut ties with provider accused of fraud

BY: - February 15, 2022

The Mississippi House of Representatives last week voted overwhelmingly to cut ties with a Medicaid provider that last year agreed to pay the state $55 million to settle claims that it fraudulently inflated the cost of prescription drugs. Ohio is the only state to actually sue over such claims and last year St. Louis-based Centene […]

DeWine: Additional transparency not needed in massive Medicaid contracts

BY: - January 24, 2022

Ohio Medicaid Director Maureen Corcoran apparently held stock in two huge health companies last year as she negotiated and signed multi-billion-dollar contracts with their subsidiaries. But she has refused to say how much she owned as she signed the deals. Nor will the man who appointed her, Gov. Mike DeWine, say he thinks Corcoran should […]

Sixth state settles with Medicaid contractor

BY: - January 11, 2022

New Hampshire became the sixth state to announce a settlement with a Medicaid managed-care company that Ohio first accused of ripping off taxpayers.  In a statement last week, New Hampshire Attorney General John M. Formella said that St. Louis-based Centene had agreed to pay the state $21.1 million to settle state claims that Centene overbilled […]

CEO of health company accused of bilking Ohio taxpayers stepping down

BY: - December 15, 2021

Six months after setting aside $1.25 billion to settle fraud claims with Ohio and 21 other states, the CEO of the nation’s largest Medicaid managed-care company has announced his retirement. Despite the scandal, Ohio continues to contract with the company. And although Centene denies it’s the case, the problems might have played into the CEO’s […]

Medicaid giant settles with fifth state

BY: - December 8, 2021

Centene, the nation’s largest Medicaid managed-care provider, has settled fraud allegations with a fifth state, Kansas Attorney General Derek Schmidt announced Monday. The $27.6 million Kansas settlement comes after Mississippi, Illinois and Arkansas announced settlements totaling $154 million. All of those follow a settlement with Ohio — the only state to actually sue the company […]

Big questions remain in huge Medicaid procurement

BY: - November 29, 2021

A Franklin County judge earlier this month dismissed a lawsuit over the largest public procurement in Ohio history. But important questions remain about potential corruption and conflicts of interest among key players who had a say in how the contracts were awarded. It’s unclear whether those questions will be answered. In April, the Ohio Department […]

Attempt to block $22 billion Medicaid contracts dismissed

BY: - November 10, 2021

A judge on Tuesday dismissed an attempt to overturn more than $22 billion worth of managed-care business as the Ohio Department of Medicaid tries to reshape the way it works with 3 million low-income and disabled Ohioans. However, questions remain about potential conflicts of interest on the part of some involved in awarding the business. […]