Health care giant Centene to pay Washington $19 million for overcharging state Medicaid program

Sunday, September 4, 2022

Fortune 50 company allegedly overcharged for pharmacy benefit management services

SEATTLE — Attorney General Bob Ferguson and the Washington State Health Care Authority announced that managed health care giant Centene will pay $19 million to Washington state. The payment resolves allegations that the Fortune 50 company overcharged the state Medicaid program for pharmacy benefit management services.

The resolution is the second-largest Medicaid fraud recovery for Washington state.

The Health Care Authority (HCA) contracts with managed care organizations like Coordinated Care of Washington, a Centene subsidiary, to manage its Medicaid program. Coordinated Care of Washington in turn contracts with pharmacy benefit managers, or PBMs, that negotiate prescription drug prices and other pharmacy related costs, including negotiating rebates and discounts on the cost of drugs.

The Attorney General’s Office and HCA’s Program Integrity Team began investigating pharmacy benefit managers in 2019 after a whistleblower provided information that they were failing to disclose true pharmacy benefits and services costs. 

Centene allegedly failed to pass on discounts it received to the state Medicaid program and inflated dispensing fees. The whistleblower later filed a separate claim against Centene.

The resolution was the result of a joint investigation conducted by the Washington Attorney General’s Office’s Medicaid Fraud Control Division and the Health Care Authority.

More information here


Anonymous,  September 4, 2022 at 4:50 PM  

Hurray for Bob! Again!

Anonymous,  September 5, 2022 at 4:28 PM  

I was surprised by the cost (before Medicare) of a prescription that I've taken for years. After reading this article I think I should alert the Office of the Atty. Gen., too!

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