Ohio AG Files Lawsuit Against Health Care Giant for Overcharging Medicaid

by J.D. Davidson

 

Ohio Attorney General Dave Yost claims in lawsuit filed Thursday a health care giant raised prices for taxpayer-funded care to maximize company profits.

Yost said Ohio sued Centene Corp. in Franklin County Common Pleas Court, alleging its subsidiary, Buckeye Health Plan, used a web of subcontractors for the provision of pharmacy benefits to be able to misrepresent pharmacy costs. That, Yost said, resulted in millions of dollars of overpayments by the Ohio Department of Medicaid.

“Corporate greed has led Centene and its wholly owned subsidiaries to fleece taxpayers out of millions. This conspiracy to obtain Medicaid payments through deceptive means stops now,” Yost said in a news release. “My office has worked tirelessly to untangle this complex scheme, and we are confident that Centene and its affiliates have materially breached their obligations both to the Department of Medicaid and the state of Ohio.”

Yost said an investigation found the company filed reimbursement requests for amounts already paid to a third party. The investigation also said the company artificially inflated dispensing fees and failed to accurately disclose to the Ohio Department of Medicaid the true cost of pharmacy services, including the discounts received.

“Centene’s actions are deeply concerning and have a direct effect on the most vulnerable Ohioans,” Yost said. “Centene has broken trust with the state of Ohio, and I intend to hold this company accountable for its deceptive practices. Today’s lawsuit is a message to corporations nationwide that Ohio will not allow them to impermissible profit at the expense of our taxpayers.”

Centene is based in St. Louis.

Yes, Every Kid

The lawsuit was filed under seal because of confidentiality and a nondisclosure agreement between the company and the Ohio Department of Medicaid. In a tweet, Yost said he hoped the court will unseal the complaint after Centene has answered.

“This is the public’s business, [and] the public has a right to know,” Yost tweeted.

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An Ohio native, J.D. Davidson is a veteran journalist with more than 30 years of experience in newspapers in Ohio, Georgia, Alabama and Texas. He has served as a reporter, editor, managing editor and publisher. He is regional editor for The Center Square

 

 

 

 

 

 

 

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