From lawsuit wins and losses to a new CEO, here are seven recent headlines about the St. Louis-based payer:
Centene subsidiary must pay $9.1M fine
Tampa, Fla.-based Sunshine State Health Plan has until April 18 to pay a $9.1 million fine after the deadline to challenge it lapsed. Florida regulators fined the subsidiary in March over software issues that led to nearly three months of delayed payments to providers. The billing issue affected 121,227 health claims of patients under 21 who are eligible for Medicaid and have chronic conditions.
Centene wins lawsuit from shareholders over Health Net purchase
A federal appeals court ruled April 7 that Centene shareholders cannot sue the payer or its board of directors for allegedly withholding information about its 2016 purchase of Health Net for $6.8 billion.
California investigating Centene after takeover of state's Medicaid program
California health officials are investigating Centene for unspecified reasons following its 2021 purchase of Magellan Health, the administrator of Medi-Cal prescriptions. The state is looking into the payer's role in providing Medi-Cal pharmacy benefits prior to the acquisition. Since the start of 2021, Centene has settled with nine states over allegations it overbilled Medicaid programs for prescription drugs and services through its pharmacy benefits arm, Envolve.
Centene sued for alleged failure to reimburse provider for COVID-19 tests
A Connecticut medical practice filed a lawsuit April 6 against Centene for allegedly violating state and federal law by failing to reimburse it for COVID-19 testing services. The provider claims it has billed Centene subsidiaries for a combined total of nearly $2.6 million for over 2,240 claims, but has only been reimbursed $187,029.
The payer appointed Vice Chair Sarah London as chief executive officer March 22. Ms. London had assisted with the day-to-day management of the company since February, when then-CEO Michael Neidorff took a medical leave of absence. Mr. Neidorff died April 7 after leading the company for over 25 years.
Centene subsidiary chosen to provide Medicaid, Medicare services in Indiana
Managed Health Services was chosen March 9 by the Indiana Department of Administration to continue serving its health plan with Medicaid and Medicare managed care services for four years.
Former employee sues Centene over alleged overtime pay withholdings after payroll hack
A former Centene employee is suing the payer for allegedly failing to administer overtime pay after a 2021 cyberattack that crippled provider and payer timekeeping and payroll systems nationwide. The plaintiff claims the company could have still tracked employees' overtime pay and alleged the company tried to avoid overtime payments by using inaccurate payroll estimates or referencing old pay periods to issue payment to hourly employees.