Centene Becomes Target as Two States Rebid Medicaid Pacts

Centene Corp.’s handling of pharmacy benefits in its managed Medicaid contracts has now become the subject of separate investigations in two states. Following the news of Ohio’s attorney general suing Centene over an alleged breach of contract, it was reported that Mississippi’s AG is looking into the Medicaid insurer’s drug benefit practices. Meanwhile, Ohio has delayed announcing the winners of its competitive managed care procurement — which Centene has bid on — and Mississippi is preparing a rebid of its own.

As part of an overhaul of its Medicaid program, Ohio in January selected Gainwell Technologies to serve as the program’s sole pharmacy benefit manager that will be rewarded for patient wellness and health outcomes. The agency said it hopes to achieve greater transparency and accountability in its $3 billion Medicaid pharmacy program and “eliminate costly duplicative processes” with the use of a single PBM.

© 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.

Related Posts

woman-getting-in-ride-share
February 2

Medicaid Beneficiaries Are Unequally Served by Non-Emergency Medical Transportation

READ MORE
magnifying-glass
February 2

With Final RADV Rule Out, MAOs Are Advised to Clean Up Risk Adjustment Practices

READ MORE
application-for-health-insurance
February 2

As Medicaid Redeterminations Loom, MCOs Can Help States Ease the Process

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today