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September 30, 2022

Nation’s Largest Medicaid Insurer to Pay $166 Million to Texas in Drug Pricing Settlement

On September 19, Kaiser Health News reported a settlement in July between Centene Corporation and the state of Texas over drug pricing practices. The allegations focused on Centene’s pharmacy benefit manager business, claiming that it overbilled the state’s Medicaid programs for prescription drugs and pharmacy services. Texas is the most recent to settle of the many states that have pursued allegations against Centene, which has also settled with Arkansas, Illinois, Kansas, Mississippi, New Hampshire, New Mexico, Ohio, and Washington, though the total number of states is not publicly known. CMS has also taken enforcement action and, in March, imposed civil monetary penalties on Centene. Despite these actions and other states that may be pursuing investigations against Centene, the company continues to renew managed-care business relationships across the country. As more states attempt to address high drug costs, pharmacy benefit managers may face increased scrutiny across their pharmacy services and prescription drug pricing practices.  

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