Centene to pay $33.3 mln to settle Washington Medicaid fraud claims

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  • Washington is 11th state to settle similar claims
  • Company accused of failing to pass drug discounts on to Medicaid

(Reuters) - Managed care giant Centene Corp has agreed to pay $33.3 million to resolve claims that it overcharged Apple Health, Washington state's Medicaid program, for pharmacy benefit management services, the latest in a string of similar settlements with states.

Under the deal announced Wednesday, the state will receive $19 million and the federal government will receive $13.3 million to be used in its administration of Apple Health, according to the office of Washington Attorney General Bob Ferguson. A whistleblower who sued the company on behalf of the state will receive $1 million.

It is the second-largest Medicaid fraud settlement in the state's history, after a $47 million settlement with Wyeth Pharmaceuticals in 2016, according Ferguson's office.

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"Medicaid dollars are a precious resource meant to fund care for the most vulnerable among us," Ferguson said in a statement. "My office works to ensure that these dollars go where they are intended — not toward fraud."

"This no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent," Centene said in a statement.

Ferguson's office said that Centene, which provides pharmacy benefit management services through its Envolve subsidiary, failed to pass discounts it received from drugmakers on to the Medicaid program.

The company previously settled similar claims with 10 other states, including New Hampshire, Ohio and Mississippi, for a total of more than $260 million. While denying any wrongdoing, it said last year that it was in negotiations with more states and had set aside $1.25 billion to settle related claims.

The case is Washington ex rel Hurst v. Centene Corp, Thurston County Superior Court, No. 22-2-01860-34.

For the state: Carrie Bashaw, Angela Coats-McCarthy and Bill Stephens of the Washington State Office of the Attorney General

For Centene: Andrea Kerstein of Locke Lord

Read more:

Centene to pay $21 mln to settle New Hampshire overcharge claims

Centene to pay $144 mln to settle Ohio, Miss. overcharge claims

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Brendan Pierson reports on product liability litigation and on all areas of health care law. He can be reached at brendan.pierson@thomsonreuters.com.