News Briefs

Centene Corp. settled two more of its PBM-related cases, reaching settlements with Illinois and Arkansas’ attorneys general to pay the states more than $71 million combined. Centene has been sued by dozens of states that allege the Medicaid-focused carrier submitted inaccurate pharmaceutical reimbursement requests that failed to properly disclose the cost of pharmacy services. Centene will pay Illinois $56,717,652 and Arkansas $15,228,318.72, and it settled with Ohio and Mississippi in June. The firm previously said it has set aside $1.1 billion to settle litigation regarding its PBM practices.

The Biden administration on Sept. 30 issued an interim final rule to further implement the No Surprises Act, the law that bans surprise medical billing. The rule drew swift condemnation from the Federation of American Hospitals (FAH) but praise from insurer trade group AHIP. The FAH called it a “total miscue” that “inserts a government standard pricing scheme arbitrarily favoring insurers,” but AHIP said the rule’s approach to settling out-of-network claims between payers and providers “signals a strong commitment to consumer affordability and lower health care spending through an independent dispute resolution process.”

© 2021 MMIT

AIS Health Staff

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