December 10, 2021

Kansas Recovers $27.6 Million from Pharmacy Benefit Manager for Alleged Overbilling of Medicaid

Lori Kalani, Bernard Nash

Cozen O'Connor

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Cozen O'Connor

Kansas AG Derek Schmidt reached a settlement with pharmacy benefit manager Centene Corp. and its subsidiaries (collectively “Centene”) to resolve allegations that it overbilled the state’s Medicaid program.
According to the AG’s office, Centene allegedly failed to represent Medicaid’s best interests in negotiations with pharmaceutical suppliers, failed to accurately report discounts it received on certain retail pharmacy claims, and artificially inflated dispensing fees reported to state regulators, among other things.
Under the terms of the settlement, Centene will pay $27.6 million to the state and agreed to revise its business practices and provide the state with access to all data related to its pharmaceutical transactions, from the point of sale through reimbursement.
As previously reported, Centene reached a $15.2 million settlement with Arkansas AG Leslie Rutledge to resolve substantially similar allegations.

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