Centene to pay Texas $166M in latest state settlement

Centene reached an $166 million agreement with Texas to settle an investigation into Medicaid fraud, state Attorney General Ken Paxton said this week.

The Texas settlement is just the latest in a string of agreements the health insurance carrier has made with states over allegations it overcharged Medicaid programs for prescription drugs.

Centene admitted no fault and said the Texas agreement “reflects the significance we place on addressing their concerns.”

The St. Louis-based insurer provides coverage to more than 1.3 million low-income people, including children, in Texas, according to state records from May 2022. There its plan is known as Superior Health Plan.

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.

Documents obtained by Kaiser Health News show Centene’s general counsel signed a settlement deal dated July 11 with Texas.

Of the settlements made public, Centene settlements so far total at least $462.7 million. Settlements have been made public in nine states, including Texas, Ohio and Illinois.

Centene has so far paid states nearly $463 million
Nine states have publicly disclosed settlements with Centene while the insurer said in July it had reached deals in 11 states.

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.

Prior to Texas, the most recent deal was announced in June when New Mexico’s attorney general said the insurer agreed to pay $13.7 million to the state. There Centene provides coverage to 1 million New Mexico residents and is known in the state as Centennial Care. Healthcare Dive