Ohio Department of Medicaid
Health care giant Centene settles with another state, California
Medicaid managed-care giant Centene has agreed to pay California $215 million to settle a drug-pricing scandal related to one that was initially detected in Ohio. In a press release last week, California Attorney General Rob Bonta said that two Centene-owned managed-care plans, California Health & Wellness and Health Net, ripped off the state’s Medicaid system, […]
Another state settles Medicaid fraud allegations with Centene
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
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 […]
11th state settles with Medicaid contractor over conduct first uncovered in Ohio
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 […]
As new Medicaid prescription program nears, some Ohio pharmacists are worried
Ohio’s community pharmacists are still worried that the state Medicaid program might drive them out of business — and deprive some communities of access to medicine. After years of complaints about under-payment and possible profiteering off of prescription drugs, the legislature in 2019 directed the Department of Medicaid to undertake a bold reform. Instead of […]
Big Ohio care provider accused of putting profit over patients — in the UK
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 […]
Medicaid director owned stock in companies she awarded huge contracts
Ohio Medicaid Director Maureen Corcoran won’t discuss them, but state ethics filings she submitted on Sunday showed that she continued to own stock in three huge health care companies last year — the same year she negotiated and signed billion-dollar contracts with their subsidiaries. Outside ethics experts have said it’s a clear conflict of interest […]
As pandemic ebbs, fears grow that Ohioans will be improperly forced off of Medicaid
As pandemic ebbs, fears grow that Ohioans will be improperly forced off of Medicaid. State to decertify recipients much faster than federal guidelines require.
Louisiana sues health care company over practices under investigation in Ohio
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 […]
Ohio Medicaid won’t say if it considered federal oversight reports in massive procurement
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 […]
Ohio Medicaid preaches transparency, withholds watchdog reports
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 […]
State employee pension fund to audit big PBM
The upcoming audit will be the fifth time in 10 years that the pharmacy benefit manager to the Ohio Employees Retirement System has been audited. An earlier version of this story said it had been audited more frequently. It’s been updated. The Ohio Employees Retirement System is seeking proposals for a firm to audit Express […]