Six individuals are suing Centene and its subsidiary Celtic Insurance for allegedly failing to pay for covered services and selling health plans on ACA marketplaces that have inaccurate provider networks, The Chicago Tribune reported Aug. 8.
Two Illinois plaintiffs, who are seeking class-action status, allege in court filings that Centene's Ambetter health plans were not accepted by providers listed as in-network and "routinely refuse to pay for medical services and medications that the plan purportedly covers."
Ambetter plans are sold on ACA exchanges in 26 states and cover more than 2 million people.
The lawsuit accuses the two companies of violating the Racketeer Influenced and Corrupt Organizations Act and the Illinois Consumer Fraud and Deceptive Business Practices Act. The plaintiffs are seeking a permanent injunction and monetary damages for alleged overpayments.
"This lawsuit is merely one more attack on the Health Insurance Marketplace and the ACA itself," Centene told the Tribune. "Centene will fight this lawsuit vigorously and will continue to uphold the important purpose of the ACA to improve the health of our communities, one person at a time."