Monday, June 14, 2021

Centene Settles for $55 Million w/Mississippi

 State Auditor Shad White and Attorney General Lynn Fitch issued the following press release.

Attorney General Lynn Fitch and Auditor Shad White reached a $55.5-million settlement with Centene, the largest Medicaid managed care organization in the United States. The settlement resolves allegations of over-payments as a part of Mississippi’s Medicaid program.

“My Office is business-friendly, and I firmly believe that businesses that operate in good faith are good partners in meeting the needs of our state,” said Attorney General Lynn Fitch. “However, I am in this Office to serve the people of Mississippi, and I fully intend to make sure they are not being cheated by Centene or anyone else. This settlement makes clear that the days of hiding behind a convoluted flow of money and numbers are over. And, I appreciate the work of Auditor White and his staff in helping achieve this success for the people.”

“I do not care how large or powerful the company is, Mississippi taxpayers deserve  to get what they paid for when the state spends money on prescription drugs, and we will stand up for the taxpayers if they do not get a square deal,” said Auditor Shad White. “I’m grateful for the joint work between my staff, the data analysts, and the Attorney General’s team for bringing this to a conclusion.”

Pharmacy Benefit Managers, or PBMs, are corporations hired by health plans, in this case, Medicaid, to help manage the plans’ prescription drug programs. In other words, they serve as middlemen, performing tasks such as contracting with and reimbursing pharmacies, creating preferred drug lists, and negotiating rebates with pharmaceutical companies.

Following suspicions that PBMs were inflating their bills, in 2019, the Auditor’s Office launched an investigation to review invoices produced by a Centene-owned company. Contracts required payments be capped by certain industry-standard prices, and the PBM was charging Medicaid more than the allowed price cap.

The agreement represents one of the largest civil settlements following an investigation by the Office of the State Auditor in Mississippi history.

In addition to the $55.5-million settlement, the agreement calls for Centene to “provide full transparency related to the adjudication and payment of all pharmacy benefit claims, including the provision of such information as is required to permit the Department of Medicaid to discern, on a claims level, the exact amount paid to the pharmacy for each pharmaceutical claim.”


Anonymous said...

Most PBM's are pure evil and another reason our medical costs are spiraling out of control.

Anonymous said...

When should I expect my check??????

Anonymous said...

Everybody just stands around with their hands in their pockets while PBMs are allowed to screw everybody. Who is their right mind allows this kind of business model to become the norm in healthcare?! They add ZERO VALUE and double the price of medicine.

Anonymous said...

All the Fitch haters must be at lunch still....

Anonymous said...

What did Fitch do here? Wasn't the legal stuff handled by some third-party attorney? The press release says Shad did the work.

Anonymous said...

Put the corporate officers and board in prison. There is no reason to allow these criminals to continue their scams.

Anonymous said...

@2:18 I’m sure Shad did all the work. Just like he did collecting money from Brett!🤣🤣🤣

Anonymous said...

Looks like the ceo is worth half a billion. I guess scamming the government is good business even if you do get caught.

Anonymous said...

Looks like it was a no fault settlement. Why would we allow scammers to save face and not admit to their crimes? Fuck these guys and fuck the politicians that allow this garbage.

Anonymous said...

David Nutt

Anonymous said...

How much did the lawyers get paid?

How much will they give to Fitch?

Anonymous said...

@1:17 who is Lynn to hate or hate on? The fact of the matter is lynn isn’t a good AG. 11-8-2022!

Anonymous said...

Fitch did nothing but release a statement saying she's all about serving the people.

Speaking of the Fitch haters all being at lunch...most of the Fitch haters go to lunch when Lynn rings the dinner bell at the office. I notice the usual Favre-junkie has chimed in, but, where's the chatter-bug who claims Shad only handles the 'low hanging fruit'?

Anonymous said...

Great job Ohio AG

Anonymous said...

Shad for AG.

Anonymous said...

At least the “haters” just take lunch. Lynn’s been missing since January 2020

Anonymous said...

To be fair to the Shad and Lynn haters, it sounds like the work on this case was outsourced to a private firm in Ridgeland, Liston & Deas. Not sure why they were not mentioned in the press release.

Anonymous said...

So the State Auditor & Attorney General agreed to a settlement? The conspirators face no jail time? Is this not a catch and pay a fine scheme for white collar crime. Seems the State Auditor was blowing his whistle about sending some county workers to jail for stealing a little county gas. What about the Chairman of the Board and President of this corporation.

Anonymous said...

She'll get my vote when they resume the death row executions.

Under Cover said...

BOLA - Lynn Fitch. Last spotted in a trench coat and brown wig at Miskelly Furniture in Pearl, The City.

Anonymous said...

2:05 am

Put the joint down


Anonymous said...

@ June 15, 2021 at 7:55 AM

Put the hotdog down.

Irony is a typo in your attempt to zing someone for a typo.

Anonymous said...

WLBT is reporting that these crooks are major donors to Tater, Delbert, mike Chaney, Gunn and other top GOP officials in the state. I wonder if they will return their stolen donation money or keep their mouth’s shut?

Out to Lunch said...

Given than Centene makes about $520,000,000.00 a year from business in MS, I don't think a $55M settlement is anything to brag about. That's pocket change to Centene. Of course, now they have plenty of money to donate to Fitch's next campaign.

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