Centene has reached a $14 million settlement with Massachusetts, the latest state to announce a deal with the insurer over allegations it overcharged for prescription drugs and pharmacy services.
The state found irregularities in pricing and reporting for pharmacy benefits and services to the state’s Medicaid program by a Centene subsidiary, attorney general Maura Healey said in a statement released Thursday.
Centene has agreed to pay $477 million in settlements so far
Healy’s office alleges that Centene and its pharmacy benefit manager, Envolve Pharmacy Solutions, failed to disclose or pass on discounts to MassHealth, which inflated fees and drug costs.
Centene operated CeltiCare in the state, providing health insurance coverage to those eligible for Medicaid. It withdrew from the market in 2017, according to a spokesperson for the state attorney general’s office. At the time, it provided coverage to about 42,000 Medicaid members in Massachusetts.
The St. Louis-based insurer is the nation’s largest Medicaid managed care firm, covering more than 15 million members.
The settlement announcement with Massachusetts comes on the heels of another deal reached with Texas for about $166 million.
Altogether, Centene now has agreed to pay at least $477 million in settlements related to its PBM. Ten state settlements have been made public.
As of July 26, Centene said it had reached no-fault agreements with 11 states, according to a filing with the U.S. Securities and Exchange Commission. The settlements are related to services its subsidiary Envolve Pharmacy Solutions provided during 2017 and 2018, Centene said.
Centene set aside $1.25 billion in a reserve during the second quarter of last year to pay for future settlements. The filings do not name the states Centene has agreed to pay, though it did disclose that the settlement reserve includes deals reached with Ohio and Mississippi.