AG Rutledge (Arkansas) reaches settlement
October 1, 2021
AG Rutledge (Arkansas) reaches $15.2 million settlement with Centene in PBM case
Centene / Envolve PBM settlements now
Ohio – $88 million
Mississippi – $55 million
Illinois – $56 million
Arkansas – $15.2 million
Arkansas Medicaid had tasked Envolve to assist in managing its prescription drug program. PBMs, such as Envolve, contract with and reimburse pharmacies for drugs, create preferred drug lists, and negotiate rebates with pharmaceutical companies. Envolve subcontracted its responsibilities for the payment of pharmacies to CVS Caremark. When Envolve reported to Arkansas Medicaid the costs paid to pharmacies for the drugs, Envolve reported inflated amounts of pharmacy costs by failing to disclose substantial discounts in ingredient costs and dispensing fees which Envolve received under the Envolve-CVS subcontract. This conduct by Envolve occurred in 2017 and 2018 and ended with termination of the Envolve-CVS subcontract.AG Rutledge (Arkansas) reaches $15.2 million settlement with Centene in PBM case
Centene must pay $15,228,318.72 to the State of Arkansas in two installments within the next year and 45 days. Going forward, Centene has agreed to provide Arkansas with full transparency related to the adjudication and payment of all pharmacy benefit claims, including the exact amount paid to the pharmacy for each pharmaceutical claim.
Rutledge has been active in a watchdog role involving the PBM industry.
She successfully won a case at the U.S. Supreme Court to uphold an Arkansas law to regulate PBMs.
https://www.arkansasonline.com/news/2021/oct/01/managed-care-company-will-pay-152-million-to/?latest
Centene quote
“This no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent,” a Centene spokesperson said in a released statement. “Importantly, this allows us to continue our relentless focus on delivering high-quality outcomes to our members.”
