CVS Caremark

Ohio suit against health care giant is sealed. Here’s why

BY: - March 16, 2021

Ohio Attorney General Dave Yost last week filed suit against the largest Medicaid managed-care provider in the United States.  The suit appears to accuse St. Louis-based Centene of improper billing, misrepresentation of its costs and other offenses. But it’s impossible to know for sure because the case was filed under seal. For the most part, […]

Will state Medicaid reforms prove we were getting a bad deal?

BY: - March 15, 2021

The Ohio Department of Medicaid in January implemented a massive overhaul to the way it administers prescription drug benefits to more than a quarter of all Ohioans. Now, the department is hiring its own middleman to handle the transactions. The department expects to save $128 million during the fiscal year starting July 1 and $184 […]

Ohio sues health giant over drug discrepancies

BY: - March 12, 2021

Ohio Attorney General Dave Yost has sued the largest Medicaid provider in the U.S. He’s claiming that, in addition to other transgressions, health care giant Centene billed the Ohio Department of Medicaid’s pharmacy program for money that had already been paid. The St. Louis-based company owns the Buckeye Health Plan, one of the five managed-care […]

Professional groups announce drug-accountability effort

BY: - December 21, 2020

A dozen Ohio professional groups on Monday announced an effort force greater accountability from powerful prescription drug middlemen known as pharmacy benefit managers, or PBMs. The PBM Accountability Project of Ohio is intended to educate policymakers and the public about problems involving PBMs and work on policies to address them. “Lawmakers and administration officials in […]

Ohio managed-care company makes big change to drug reimbursements

BY: - November 2, 2020

After years of complaints by community pharmacies, Ohio's largest Medicaid managed-care company has announced a huge overhaul to the way it reimburses them for prescription drugs.

Are companies being sued by Ohio also bidding on new Medicaid contract?

BY: - August 19, 2020

The Ohio Department Medicaid won't say whether it will award a big contract to companies against whom the state has filed lawsuits claiming the companies ripped off state agencies in transactions involving prescription drugs.

Feds said to be investigating largest Medicaid provider in the U.S.

BY: - July 20, 2020

Federal officials are probing actions taken in Ohio in 2017 by the largest Medicaid managed care provider in the United States, a source familiar with the investigation has told Ohio Capital Journal.  The U.S. Centers for Medicaid and Medicare Services declined to confirm or deny the existence of an investigation. But the source said the […]