Centene agrees to pay Iowa $44 million to settle Medicaid fraud claims

Missouri-based Centene Corp. has agreed to pay Iowa $44.4 million to settle claims that it defrauded the state’s Medicaid system.

That makes it the latest state to settle claims that were originally raised in Ohio in 2021.

Centene, the nation’s largest Medicaid managed-care company, agreed to pay the money over claims that its subsidiary, Iowa Total Care, overbilled taxpayers for prescription drugs in transactions handled by a Centene-owned drug middleman, Envolve.

Medicaid managed-care companies such as Iowa Total Care contract with state Medicaid agencies to sign up patients and create networks of providers such as doctors and dentists to care for them. Pharmacy benefit managers such as Envolve contract with such managed-care organizations to create lists of covered drugs, contract with pharmacies and reimburse them for the drugs they dispense.

In March 2021, Ohio Attorney General Dave Yost sued his state’s Medicaid managed-care provider, Buckeye Health Plan. That suit accused the company of working through Envolve and another Centene-owned pharmacy middlemen to overcharge taxpayers by millions of dollars for prescription drugs.

Source: Centene agrees to pay Iowa $44 million to settle Medicaid fraud claims / Missouri Independent

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