Medicaid Managed Care

Centene settles with Texas over conduct first detected in Ohio

BY: - September 23, 2022

Centene settles with Texas over conduct first detected in Ohio.

Louisiana sues health care company over practices under investigation in Ohio

BY: - April 22, 2022

Louisiana is suing health care giant UnitedHealth over several business practices, saying it is seeking “to recover billions of dollars in inflated prescription-drug prices” for the state Medicaid program. Among its allegations, the state accuses the company of gaming federal oversight reports meant to ensure that at least 85% of the money it gets from […]

That’s privileged: Medicaid won’t say what it did to justify denying records

BY: - April 7, 2022

The Ohio Department of Medicaid is denying public access to oversight reports submitted by its billion-dollar managed-care contractors. But it won’t describe the process it used in determining that information in the reports qualifies as trade secrets. That information is privileged, said a spokeswoman for the department, which claims to value transparency. Even though some […]

Ohio Medicaid preaches transparency, withholds watchdog reports

BY: - March 18, 2022

Ohio Medicaid director Maureen Corcoran often stresses the importance of transparency in delivering $35 billion worth of health care each year to Ohio’s poor and disabled. But in response to an open-records request, the department last week refused to provide copies of key, federally required reports meant to ensure that its biggest contractors aren’t gouging […]

Attorney General seeks financial info from Medicaid contractors

BY: - March 11, 2022

In the past month, Ohio Attorney General Dave Yost has sought financial information from the state’s five managed-care contractors, documents received in response to an open-records request show.  The AG won’t discuss ongoing investigations, but he might be looking into whether some practices by subcontractors who manage pharmacy benefits violate state law or federal regulations. […]

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 […]

In sworn statements, Ohio Medicaid director might have contradicted herself

BY: - November 15, 2021

Did Ohio Medicaid Director Maureen Corcoran know earlier this year that she owned stock in health giants CVS and UnitedHealth as she awarded enormous contracts to subsidiaries of both? In separate sworn statements, she seems to be saying no and yes. After a month of questions, Corcoran still hasn’t disclosed just how much stock she […]

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. […]

Company hints that Medicaid director acted improperly. It’s happened before

BY: - October 18, 2021

A company that was passed over for a piece of the biggest set of contracts ever let by the state of Ohio hinted in court Wednesday that Ohio Medicaid Director Maureen Corcoran might have acted improperly. Kirsten R. Fraser, an attorney for managed-care provider Paramount Advantage, asked a Medicaid official if Corcoran or one of […]

Disappointed Medicaid bidder focuses on inconsistencies

BY: - October 14, 2021

A Toledo company that’s trying to stop a group of contracts worth billions from going forward on Wednesday focused on what it saw as inconsistencies in the way the Ohio Department of Medicaid procured them. And it again hinted at possible improprieties by Medicaid Director Maureen Corcoran. It was the second day in a trial […]

Bias, conflict were present in $22 billion Ohio Medicaid contract, bidder says

BY: - October 13, 2021

A Toledo-area health care provider says that it’s received top ratings in the eight years it’s provided managed-care services to the Ohio Medicaid program. It hinted that it was the victim of bias and possible conflicts of interest earlier this year when it missed out on a share of a five-year, $22 billion program meant […]

Analysis: Billion-dollar whitewash?

BY: - June 16, 2021

In the wake of a blockbuster settlement of fraud claims, the top executive at the nation’s biggest Medicaid contractor was eager Wednesday to put the matter behind the company, which derives most of its revenue from taxpayers. But even though executives repeatedly used some form of the word “transparency,” they seem to be trying to […]