Centene to Pay $215 Million to California over Medicaid Overbilling Allegations

  • California AG Rob Bonta settled with pharmacy benefit manager (PBM) Centene Corporation and its subsidiaries in connection with alleged overcharges by Centene to California’s Medi-Cal program.
  • AG Bonta alleges that Centene overcharged the Medi-Cal system by reporting inflated prescription drug costs. In particular, he alleges that Centene leveraged its PBM contracts to save its managed care plans $2.70 per prescription drug claim over a two-year period, but failed to disclose or pass on those discounted fees to Medi-Cal.
  • Under the terms of the settlement, Centene will pay $215 million to the state, which AG Bonta represents is twice the value of the inflated price reporting.
  • California is the latest in a string of states to settle with Centene over similar allegations. We recently reported on the company’s $66.5 million settlement with Indiana.