Centene to pay $66.5 million in Indiana Medicaid drug pricing settlement

By: - February 1, 2023 11:39 am

State wins big pharmacy over-billing settlement. (Getty Images)

Health care services company Centene Corp. will pay Indiana nearly $66.5 million to resolve allegations that it overcharged the state’s Medicaid program for pharmacy services, Attorney General Todd Rokita’s office announced Wednesday.

Centene admitted no liability or law-breaking in the settlement.

“Companies must be held accountable for their actions,” Rokita said in a news release. “On Hoosiers’ behalf, my team and I are committed to making sure that happens.”

His office accused the company of “fail[ing] to disclose true pharmacy benefits and services costs” while acting as a pharmacy benefit manager — a third-party group that administers prescription drug programs for a range of health plan types. 

The office said Centene was contracting with pharmacies and reimbursing them for filling prescriptions on behalf of insurance plans from the state of Indiana. Centene allegedly “inflated” some fees, overcharging the state’s Medicaid program.

Indiana is one of at least 18 states to investigate Centene’s activities, according to the release.

Centene first settled with Ohio and Mississippi in June 2021 and since then has settled with more than a dozen states. Investors have even sued the company over the fraud claims and attached $1.3 billion total price tag, according to Bloomberg Law.

Centene will pay out the Indiana settlement in two installments one within a month of the agreement date and the other within a year of the first. The Indiana Family and Social Services Administration will get $17.2 million, and Rokita’s office will get the rest, according to the settlement.

Law firm Liston & Deas earned approximately $3.3 million off the suit, according to the contingency fee contract.

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Leslie Bonilla Muñiz
Leslie Bonilla Muñiz

Leslie joins the Indiana Capital Chronicle after covering city government and urban affairs for the Indianapolis Business Journal for more than a year. She graduated from Northwestern University in March 2021, and has reported for the Chicago Tribune, Voice of America and student publications in Evanston, Illinois, Washington, D.C., and Doha, Qatar.