Dive Brief:
- Centene is facing a $9 million fine from Florida health regulators for incorrectly denying claims for more than 121,000 Medicaid members.
- Florida is freezing enrollment in Centene's plans there, according to a March 17 letter sent to the CEO of the Florida division, known as the Sunshine State Health Plan.
- In a statement, Centene said the claims payment issues have been resolved and corrective actions have been shared with Florida's health regulator.
Dive Insight:
The denials were caused by "internal system errors," according to the letter from the enforcement unit of Florida's Agency for Health Care Administration.
"We know that we created a number of challenges for our partners that did not meet the standards we set for ourselves or our contractual obligation to the state of Florida," Centene said in a statement to Healthcare Dive.
Centene is the nation's largest Medicaid managed care provider, providing coverage to more than 26 million people across the country.
In recent months, Centene has reached settlements with various states over allegations that it overcharged state Medicaid programs for prescription drugs.
In January, Centene reached a deal with New Hampshire, agreeing to pay $21.1 million to settle those allegations.
Centene has made similar deals in Arkansas, Illinois and Mississippi.
Recently, the St. Louis based insurer has experienced a shakeup of its top management. Sarah London, a former Optum executive, recently took over as CEO, replacing longtime leader Michael Neidorff.
London, 41, specializes in data and technology, likely a signal of where the company is headed in the years to come.
The executive changes follow activist pressure in recent months as the company reevaluates its assets and looks to shed non-core units.