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Centene Settles Ohio Suit Alleging Medicaid Fraud For $88 Million

Ohio Attorney General Dave Yost
Julie Carr Smyth
In this Feb. 20, 2020 file photo, Ohio Attorney General Dave Yost speaks in Columbus, Ohio.

Ohio has settled a lawsuit it filed in March with a pharmacy benefits manager it accused of using subcontractors to overcharge Ohio’s Medicaid program.

Attorney General Dave Yost said Centene initiated the talks that led to the $88.3 million settlement after the state alleged the pharmacy benefit manager overbilled Ohio's Medicaid department for pharmacy services it provided

“We didn’t seek out a settlement. Centene initiated the negotiations and said, ‘what’s is going to take to resolve this matter?’" Yost said in announcing the settlement.

His lawsuit accused Centene, through its Buckeye Health Plan, of double billing, inflating dispensing fees and claiming that they paid more to pharmacists than they actually did. Centene said in a statement the agreement denies any liability for these practices.

Yost said in response: “I will accept an apology note that has a dollar sign and many zeroes after it.”

In filing the suit, the state froze Centene’s $20 billion contract for managed care services for Ohio Medicaid.

Centene also settled a suit with Mississippi for $55 million. Yost said while he expects other states to sue, the settlement guarantees none will get more money than Ohio.

PBMs are third-party companies that help manage health care plans. That includes Medicaid, which covers 2.9 million Ohioans.

The Associated Press contributed to this story.

Copyright 2021 The Statehouse News Bureau. To see more, visit The Statehouse News Bureau.

Karen Kasler
Contact Karen at 614/578-6375 or at kkasler@statehousenews.org.