$14 Million Settlement Reached in Case Between PBM and Largest Managed Care Payer in US

MassHealth has reached a $14 million settlement with the Centene Corporation, a major pharmacy benefit manager (PBM), as announced by the state’s attorney general (AG), Maura Healey. MassHealth is the largest Medicaid managed care payer in the US and has been embroiled in a legal battle with Centene, over claims the company had failed to provide the discounts and rebates it promised to the state, jacking up costs.

According to the AG’s office, “Following a series of investigations and settlements by state officials across the country, AG Healey’s Office reviewed the operations of Centene in Massachusetts, including its pharmacy benefits manager (PBM), Envolve Pharmacy Solutions, Inc. This review discovered irregularities in the pricing and reporting of pharmacy benefits and services to MassHealth by Centene’s subsidiary companies.”

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(Source: Mass.gov, September 19^th, 2022)