Medicaid Managed Care

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 […]

Two additional states might be eyeing litigation against health care giant

BY: - April 26, 2021

Add Kansas and Arkansas to the list of states that might be considering litigation against the largest Medicaid managed-care contractor in the country. Ohio already is suing St. Louis-based Centene, claiming that the company used layers of middlemen to overbill the state by tens of million of dollars for prescription drugs — allegations Centene adamantly […]

Ohio’s suing a huge Medicaid contractor. Mississippi’s investigating whether to follow suit

BY: - April 19, 2021

Ohio might have started a trend last month when it filed suit against the largest Medicaid contractor in the United States. Now Mississippi is considering litigation of its own. A spokeswoman for Mississippi Attorney General Lynn Fitch didn’t respond to requests for comment last week, but that office told the Daily Journal in Mississippi that […]

Conflicting corporate claims at the heart of Ohio’s blockbuster Medicaid suit

BY: - April 12, 2021

Two mega-corporations appear to be claiming they did the same work for Medicaid — Ohio’s $24 billion-a-year program that provides health care to the poorest 25% of state residents.  Since the companies received at least $53 million for the work in 2017 alone, the conflicting claims could be a big problem — one with potential […]

COMMENTARY

State budget must provide adequate resources to fully implement new Medicaid managed care contract

BY: - February 19, 2021

Ohio is on the brink of making historic changes to its Medicaid program. For the first time since 2012, the Department of Medicaid is renegotiating its contracts with private insurance companies that are tasked with administering most of the state’s health care program for low-income residents. If these changes are fully implemented then vulnerable Ohioans, […]