No Fault, But Millions To Pay In Pharmacy Benefits Settlements With Ohio And Mississippi

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  • Ohio AG Dave Yost and Mississippi AG Lynn Fitch reached no-fault agreements with healthcare company Centene Corporation and its subsidiaries (collectively, “Centene”), over allegations that two of its subsidiaries—Buckeye Health Plan Community Solutions, Inc. (“Buckeye”) and Envolve Pharmacy Solutions, Inc. (“Envolve”)—overbilled the states’ Medicaid programs for pharmacy services, in violation of provider agreements with the states.
  • According to AGs Fitch and Yost, Buckeye and Envolve allegedly misrepresented the costs of pharmacy services—including prescription drugs—to the states, and charged the states more than allowed under the price caps established in its provider agreements, among other things.
  • Under the terms of the agreements, Centene will pay $88.3 million to Ohio, and $55.5 million to Mississippi.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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