Centene Alleges ‘Misunderstanding,’ Seeks Transparent Resolution in Ohio Medicaid Dispute

As Centene Corp. defends allegations made by the Ohio Attorney General regarding its pharmacy benefit practices, recent court filings indicate the company’s strong desire to clear the air in a public way. At the same time, Centene and its affiliates allege that the plaintiffs lack a basic understanding of Medicaid billing and pharmacy benefits.

“There are no secrets here; there is nothing that needs to be hidden or, in fact, that even justifies the filing of this lawsuit,” argue Centene, Buckeye Community Health Plan and Envolve Pharmacy Solutions in a March 2 filing in the case, Ohio Dept. of Medicaid, et al. v. Centene Corporation, et al. (No. 21-cv-1502). Although the case was originally filed under seal in the Franklin County Court of Common Pleas, Centene requested that it be unsealed for the sake of transparency, and it has since moved to the U.S. District Court for the Southern District of Ohio. “The Complaint in this case reflects a misunderstanding of the admittedly complex world of Medicaid accounting and billing” in which MCOs and PBMs like Buckeye and Envolve operate, and the allegations can be “easily explained away once the facts about Buckeye’s reporting and billings” to the Ohio Dept. of Medicaid (ODM) are understood, contend the defendants.

© 2023 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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