MM Curator summary
Mississippi is investigating Centene for similar issues in the OH-Centene lawsuit.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
The Mississippi Division of Medicaid is investigating Centene subsidiary Magnolia Health to determine whether it used subcontractors to misrepresent pharmacy costs, the Northeast Mississippi Daily Journal reported March 23.
The state attorney general’s office hired outside attorneys to investigate the matter and potentially pursue claims, as misrepresenting pharmacy costs could have resulted in millions of dollars in overpayments by Mississippi’s Medicaid department, according to the Daily Journal.
Magnolia Health and two other contractors manage health insurance benefits for about 480,000 Mississippians who are a part of the state’s Medicaid managed care system, and the state’s Medicaid department pays the companies a set rate per patient.
Mississippi’s investigation is similar to an Ohio probe announced March 11 by the state’s attorney general, Dave Yost. He filed a lawsuit against Centene claiming the company’s subsidiary, Buckeye Health Plan, used a web of subcontractors to misrepresent pharmacy costs.
Magnolia Health uses at least two companies (Envolve Pharmacy Solutions and RxAdvance) to get medications to Medicaid beneficiaries, according to the Daily Journal.
Clipped from: https://www.beckershospitalreview.com/pharmacy/mississippi-medicaid-officials-investigate-centene-s-pharmacy-payments.html