The Mississippi Attorney General's office is investigating a Centene Corp. subsidiary for allegedly obscuring and overcharging the Mississippi Department of Medicaid by millions of dollars in drug costs.
The state attorney general's office said it has hired outside attorneys to probe the matter and potentially pursue claims worth millions of dollars in overpayments, as first reported by the Northeast Mississippi Daily Journal. The Mississippi Department of Medicaid contracted with Centene subsidiary Magnolia Health to help manage care for the 480,000 lower-income adults and children members of the state's Medicaid system. Magnolia subcontracts with Envolve Pharmacy Solutions to dispense drugs to beneficiaries.
A spokesperson for the attorney general's office said it was too early to discuss the specifics of the case but said Mississippi's claims are similar to Ohio's.
Centene called the claims "unfounded" and said the company is "committed to the highest levels of quality and transparency." The insurer added that the state reviews its pharmacy contracts before they go into effect and that Centene's services saved taxpayers millions of dollars compared to market-based drug pricing. In 2020, Centene's Medicaid business brought in $74.7 billion in revenue, up 44% from the $51.8 billion in 2019.
"Envolve will aggressively defend the integrity of the pharmacy services it has provided to the State of Mississippi," Centene said in a statement.
In early March, Ohio Attorney General Dave Yost sued Centene, alleging the St. Louis-based insurer used a "web of subcontractors" to obscure drug costs and overcharge the state's Medicaid program by millions of dollars in pharmacy benefits. In 2019, Yost also filed a suit against UnitedHealth Group subsidiary OptumRx, aiming to recover the $16 million that he said the pharmacy benefit manager overcharged the state's Medicaid program for drugs.
UnitedHealth Group—along with Molina Healthcare—also helps administer Mississippi's $3 billion Medicaid managed-care system, named MississippiCAN.
In a Facebook post, Mississippi Rep. Becky Currie, R-Brookhaven, a nurse who serves on the House Medicaid Committee, said she has "shouted at the top of my lungs for 8 years" that the insurers that run MississippiCAN are "ripping us off," calling for an audit of the program. The attorney general's investigation comes as the state prepares to bid out new, five-year managed care contracts for MississippiCAN.
"If they have stolen millions from Mississippi, I want to know, and I want to know now," Currie wrote. "We are about to sign another three-year contract with them."