Company That Took Over California's Medicaid Drug Program Will Now Pay $166M To Texas In Pricing Settlement

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California health officials have said they are investigating the company over alleged overbilling for Medi-Cal pharmacy services.

Most states contract with private insurance companies such as Centene to cover people who have disabilities or earn low incomes in their state Medicaid programs, which are jointly paid for by state and federal taxpayers. In many of those states, the insurance company handles Medicaid prescription medications through what is called a pharmacy benefit manager, or PBM, to get lower prices.between drugmakers and health insurers and as intermediaries between health plans and pharmacies.

Exactly how the company may have overcharged states, or failed to meet the terms of its contracts, is not disclosed in the settlements, said Still, the settlements haven’t caused the business relationships to end. In Ohio and Mississippi, the company has renewed key state managed-care contracts after settling the pharmacy benefit allegations.And just last week, Centene announced that Texas had renewed the contract of the company’s Texas affiliate, Superior HealthPlan, to deliver health care to foster care children and youths — despite the July settlement over its prescription drug management.

 

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