Centene Corp., the Clayton-based managed health care provider, has agreed to pay New Hampshire $21.1 million to settle claims by the state that it inaccurately reported pharmacy benefit services costs, New Hampshire's attorney general said last week.
This is the sixth state to settle with Centene regarding its pharmacy benefit services.
Centene (NYSE: CNC) and its affiliates Granite State Health Plan Inc. and NH Healthy Families Inc. are responsible for one of the three health plans associated with New Hampshire’s Medicaid Care Management Program. New Hampshire said it launched its review of Centene's pharmacy benefit services, which it provides through its Envolve Pharmacy Solutions Inc. subsidiary, after similar investigations in other states became public.
The New Hampshire settlement amount was determined based on a national formula Centene has used to settle similar cases, officials said. Centene has agreed to pay more than $243 million in deals with five other states since July, according to Reuters.
New Hampshire's settlement resolves the state's claims that Centene inaccurately reported pharmacy benefit services costs in the Medicaid program, including prescription drug pricing, officials said. The settlement covers the period of Jan. 1, 2016, through Dec. 30, 2021.
In the agreement, Centene denied liability, wrongdoing or violation of federal or state laws. “This no-fault agreement reflects our commitment to prompt and transparent resolution of this matter and relentless focus on delivering high-quality healthcare outcomes to our members in the Granite State,” the company said in a statement to the Associated Press.
"This settlement represents a significant recovery for New Hampshire taxpayers that adequately compensates the State for the financial harm it has suffered," New Hampshire Attorney General John Formella said in a Jan. 6 press release. "We appreciate Centene's willingness to engage with the State to resolve this matter quickly and fairly. While this settlement is significant, we will not fall victim to complacency and will continue to take action to protect the financial interests of the State and its taxpayers."
Most recently, Centene last month reached a $27.6 million settlement with the state of Kansas over its pharmacy benefit management practices for its Medicaid program.
In September, Centene entered no-fault agreements with the attorneys general of Arkansas and Illinois – for $15 million and $57 million, respectively – to resolve claims related to services provided by its Envolve Pharmacy Solutions unit.
In June last year, Centene agreed to pay $88 million to Ohio’s Medicaid program to settle a lawsuit over how it charged the state for prescriptions. The company also reached a similar $55 million settlement with Mississippi last summer. Centene said in a June regulatory filing that it was setting aside $1.1 billion to resolve similar possible allegations in other states.
With operations in all 50 states, Centene is the nation's largest Medicaid managed care provider, with nearly 76,000 employees companywide and more than 5,500 workers in St. Louis.
Centene projected its 2021 revenue at more than $125 billion. For the nine months ended Sept. 30, Centene reported net earnings attributable to the company of $748 million on total revenue of $93.4 billion.