Centene reaches $215 million settlement addressing California drug overcharges

By Jonathan Stempel

(Reuters) – Centene Corp has reached a $215.4 million settlement with California to resolve accusations it overcharged a state program for affordable healthcare by falsely inflating its costs for providing prescription drugs to patients.

California Attorney General Rob Bonta announced the settlement on Wednesday with the managed care company, which denied liability and wrongdoing but considered the settlement “fair, reasonable, and adequate.”

State investigators said that in 2017 and 2018 Centene took advantage of its pharmacy benefit manager contracts to save two of its managed care plans, California Health & Wellness and Health Net, $2.70 per prescription drug claim.

The St. Louis-based company then failed to pass on these savings to California’s Medi-Cal program, inflating its costs, the investigators found.

Bonta said Centene’s conduct violated California’s False Claims Act.

He also said the $215.4 million payment recovers twice the value of the overcharges and provides full restitution to Medi-Cal.

“”Medi-Cal is a lifeline that provides access to free or affordable healthcare services for millions of Californians,” Bonta said in a statement. “When companies overcharge the Medi-Cal system, it drains valuable resources from the people who rely on this care.”

In a statement, Centene said it respected its “deep and critically important relationships” with U.S. states, and was committed to providing “local, simple and transparent” healthcare.

On Tuesday, Centene said profit in 2022 totaled $1.2 billion, or $2.07 per share, on revenue of $144.5 billion.

(Reporting by Jonathan Stempel in New York; Editing by Leslie Adler and Jonathan Oatis)