Ohio Department of Medicaid

11th state settles with Medicaid contractor over conduct first uncovered in Ohio

BY: - August 29, 2022

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

BY: - August 9, 2022

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

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 […]

Medicaid director owned stock in companies she awarded huge contracts

BY: - May 17, 2022

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

BY: - April 25, 2022

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

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 […]

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 […]

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 […]

State employee pension fund to audit big PBM

BY: - March 11, 2022

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 […]

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 […]

Medicaid provider to drop legal action against state

BY: - January 5, 2022

An Ohio-based Medicaid managed-care company is poised to end its legal action against the state. Last year it accused the Ohio Department of Medicaid of bias and conflicts in a $22 billion bidding process. Toledo-based Paramount Advantage now says that if the department approves a deal for Anthem to take over Paramount’s patients, it will […]