Giant managed care group to pay over $1 billion to settle drug overcharging claims

  • Centene has resolved misrepresentation allegations, while denying them.
  • The company is the largest insurer on the Obamacare health insurance marketplace.
  • Centene is the biggest managed care group serving Medicaid.
  • The company is also lead provider of health care for the U.S. military

Centene, the biggest Managed Care Organization serving the poor through Medicaid, has reached agreements on charges that its pharmacy benefits manager, Envolve, misrepresented pharmacy costs.

Officials in Ohio and Mississippi accused Centene of misrepresentations that resulted in tens of millions of dollars in overpayments.

While denying liability, Centene has agreed to pay $88 million to Ohio and $55 million to Mississippi. 

That’s just the tip of the iceberg since other states have lodged similar complaints.

Centene estimates it will cost approximately $1.1 billion more to resolve the other allegations.

Besides being the largest Medicaid provider of managed care, Centene is also the largest health insurance carrier on the Obamacare Health Insurance Marketplace and one of the largest providers of managed care for the U.S. military, their families, and veterans.

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top