ST. LOUIS, June 14, 2021 /PRNewswire/ -- Centene
Corporation (NYSE: CNC) today announced that it has reached
no-fault agreements with the Attorneys General of Ohio and Mississippi to resolve claims made by the
states related to services provided by Envolve Pharmacy Solutions,
Inc. (Envolve), its pharmacy benefits manager subsidiary.
Under the terms of these agreements, Centene will pay
$88 million to Ohio and $55
million to Mississippi. The
practices described in the settlement focus on the structure and
processes of Envolve, primarily during 2017 and 2018. In the
settlements, the Company denies any liability for these practices.
As a result of the settlement, the Ohio Attorney General's litigation against the
Company will be dismissed.
In early 2019, Centene proactively restructured its pharmacy
benefits operations to create a more transparent relationship
between its health plans and its pharmacy benefits manager. Since
that time, Centene has also aligned all Medicaid, Medicare and
health insurance marketplace products on transparent pharmacy
networks to eliminate spread pricing. Going forward, Envolve will
operate as an administrative service provider, not a PBM, on behalf
of Centene's local health plans to further simplify our pharmacy
operations.
"We respect the deep and critically important relationships we
have with our state partners," said Brent
Layton, Centene's President of Health Plans, Markets and
Products. "These agreements reflect the significance we place
on addressing their concerns and our ongoing commitment to making
the delivery of healthcare local, simple and transparent.
Importantly, putting these issues behind us allows us to continue
our relentless focus on delivering high-quality outcomes to our
members."
Additionally, the Company is in discussions with a plaintiff's
group led by the law firms of Liston & Deas and Cohen &
Milstein in an effort to bring final resolution to these concerns
in other affected states. Consistent with those discussions,
Centene has recorded a reserve estimate of $1.1 billion related to this issue, exclusive of
the above settlements.
Centene Corporation is a leading multi-national healthcare
enterprise that is committed to helping people live healthier
lives. The Company takes a local approach – with local brands and
local teams - to provide fully integrated, high-quality, and
cost-effective services to government-sponsored and commercial
healthcare programs, focusing on under-insured and uninsured
individuals.
About Centene Corporation
Centene, a Fortune 50
company, offers affordable and high-quality products to nearly 1 in
15 individuals across the nation, including Medicaid and Medicare
members (including Medicare Prescription Drug Plans) as well as
individuals and families served by the Health Insurance
Marketplace, the TRICARE program, and individuals in correctional
facilities. The Company also serves several international markets,
and contracts with other healthcare and commercial organizations to
provide a variety of specialty services focused on treating the
whole person. Centene focuses on long-term growth and the
development of its people, systems and capabilities so that it can
better serve its members, providers, local communities, and
government partners.
Centene uses its investor relations website to publish
important information about the company, including information that
may be deemed material to investors. Financial and other
information about Centene is routinely posted and is
accessible on Centene's investor relations
website, http://investors.centene.com/.
Forward Looking Statements
All statements in this press release that are not purely
historical facts are forward-looking statements within the meaning
of Section 27A of the Securities Act of 1933, as amended and
Section 21E of the Securities Exchange Act of 1934, as amended.
Without limiting the foregoing, forward-looking statements often
use words such as "believe," "anticipate," "plan," "expect,"
"estimate," "intend," "seek," "target," "goal," "may," "will,"
"would," "could," "should," "can," "continue" and other similar
words or expressions (and the negative thereof).
In particular, these statements include, without limitation,
statements about our settlements with Ohio and Mississippi to resolve claims made by the
states with regard to practices at Envolve, our pharmacy benefits
manager subsidiary, and other possible future claims and
settlements related to the practices at Envolve and our
ability to settle claims with other states within the reserve
estimate we have recorded and on other acceptable terms, or at all,
future operating or financial performance, market opportunity,
growth strategy, competition, expected activities in completed and
future acquisitions, including statements about the impact of our
proposed acquisition of Magellan Health, Inc. (Magellan Health and
such acquisition, the Magellan Acquisition), our recently completed
acquisition of WellCare Health Plans, Inc. (WellCare and such
acquisition, the WellCare Acquisition), other recent and future
acquisitions, investments and the adequacy of our available cash
resources. These forward-looking statements reflect our
current views with respect to future events and are based on
numerous assumptions and assessments made by us in light of our
experience and perception of historical trends, current conditions,
business strategies, operating environments, future developments
and other factors we believe appropriate. By their nature,
forward-looking statements involve known and unknown risks and
uncertainties and are subject to change because they relate to
events and depend on circumstances that will occur in the future,
including economic, regulatory, competitive and other factors that
may cause our or our industry's actual results, levels of activity,
performance or achievements to be materially different from any
future results, levels of activity, performance or achievements
expressed or implied by these forward-looking statements. These
statements are not guarantees of future performance and are subject
to risks, uncertainties and assumptions. All forward-looking
statements included in this press release are based on information
available to us on the date of this press release. Except as may be
otherwise required by law, we undertake no obligation to update or
revise the forward-looking statements included in this press
release, whether as a result of new information, future events or
otherwise, after the date of this press release. You should not
place undue reliance on any forward-looking statements, as actual
results may differ materially from projections, estimates, or other
forward-looking statements due to a variety of important factors,
variables and events including, but not limited to: the impact of
COVID-19 on global markets, economic conditions, the healthcare
industry and our results of operations and the response by
governments and other third parties; the risk that regulatory or
other approvals required for the Magellan Acquisition may be
delayed or not obtained or are subject to unanticipated conditions
that could require the exertion of management's time and our
resources or otherwise have an adverse effect on us; the
possibility that certain conditions to the consummation of the
Magellan Acquisition will not be satisfied or completed on a timely
basis and accordingly the Magellan Acquisition may not be
consummated on a timely basis or at all; uncertainty as to the
expected financial performance of the combined company following
completion of the Magellan Acquisition; the possibility that the
expected synergies and value creation from the Magellan Acquisition
or the WellCare Acquisition (or other acquired businesses) will not
be realized, or will not be realized within the respective expected
time periods; the risk that unexpected costs will be incurred in
connection with the completion and/or integration of the Magellan
Acquisition or that the integration of Magellan Health will be more
difficult or time consuming than expected; the risk that potential
litigation in connection with the Magellan Acquisition may affect
the timing or occurrence of the Magellan Acquisition or result in
significant costs of defense, indemnification and liability; a
downgrade of the credit rating of our indebtedness, which could
give rise to an obligation to redeem existing indebtedness; the
inability to retain key personnel; disruption from the
announcement, pendency, completion and/or integration of the
Magellan Acquisition or from the integration of the WellCare
Acquisition, or similar risks from other acquisitions we may
announce or complete from time to time, including potential adverse
reactions or changes to business relationships with customers,
employees, suppliers or regulators, making it more difficult to
maintain business and operational relationships; our ability to
accurately predict and effectively manage health benefits and other
operating expenses and reserves, including fluctuations in medical
utilization rates due to the impact of COVID-19; competition;
membership and revenue declines or unexpected trends; changes in
healthcare practices, new technologies, and advances in medicine;
increased healthcare costs; changes in economic, political or
market conditions; changes in federal or state laws or regulations,
including changes with respect to income tax reform or government
healthcare programs as well as changes with respect to the Patient
Protection and Affordable Care Act ("ACA") and the Health Care and
Education Affordability Reconciliation Act, collectively referred
to as the ACA and any regulations enacted thereunder that may
result from changing political conditions, the new administration
or judicial actions, including the ultimate outcome in "Texas v.
United States of America"
regarding the constitutionality of the ACA; rate cuts or other
payment reductions or delays by governmental payors and other risks
and uncertainties affecting our government businesses; our ability
to adequately price products; tax matters; disasters or major
epidemics; changes in expected contract start dates; provider,
state, federal, foreign and other contract changes and timing of
regulatory approval of contracts; the expiration, suspension, or
termination of our contracts with federal or state governments
(including but not limited to Medicaid, Medicare, TRICARE or other
customers); the difficulty of predicting the timing or outcome of
pending or future legal and regulatory proceedings or matters,
including the ongoing regulatory review of claims against our PBM
business or whether additional claims, reviews or
investigations relating to our PBM business will be brought by
other states, the federal government or shareholder litigants, or
government investigations; challenges to our contract awards;
cyber-attacks or other privacy or data security incidents; the
exertion of management's time and our resources, and other expenses
incurred and business changes required in connection with complying
with the undertakings in connection with any regulatory,
governmental or third party consents or approvals for acquisitions,
including the Magellan Acquisition; disruption caused by
significant completed and pending acquisitions making it more
difficult to maintain business and operational relationships; the
risk that unexpected costs will be incurred in connection with the
completion and/or integration of acquisition transactions; changes
in expected closing dates, estimated purchase price and accretion
for acquisitions; the risk that acquired businesses will not be
integrated successfully; restrictions and limitations in connection
with our indebtedness; our ability to maintain or achieve
improvement in the Centers for Medicare and Medicaid Services star
ratings and maintain or achieve improvement in other quality scores
in each case that can impact revenue and future growth;
availability of debt and equity financing, on terms that are
favorable to us; inflation; foreign currency fluctuations; and
risks and uncertainties discussed in the reports that Centene has
filed with the Securities and Exchange Commission. This list of
important factors is not intended to be exhaustive. We discuss
certain of these matters more fully, as well as certain other
factors that may affect our business operations, financial
condition and results of operations, in our annual report on Form
10-K, quarterly reports on Form 10-Q and current reports on Form
8-K. Due to these important factors and risks, we cannot give
assurances with respect to our future performance, including
without limitation our ability to maintain adequate premium levels
or our ability to control our future medical and selling, general
and administrative
costs.
View original
content:http://www.prnewswire.com/news-releases/centene-reaches-no-fault-agreements-with-ohio-and-mississippi-to-resolve-pharmacy-subsidiary-claims-301311468.html
SOURCE Centene Corporation