Centene Corporation Health Net Acquisition Impact and Controversies

Centene Corporation's acquisition of Health Net was a significant deal that had far-reaching consequences. The acquisition was announced in 2016 and was completed in 2017.

The acquisition gave Centene a major presence in the California health insurance market. Health Net was a well-established health insurance company in California, with a large customer base.

One of the key impacts of the acquisition was the creation of a new entity called Ambetter. Ambetter was created to serve the individual and family market in California.

Centene Corporation's leadership has undergone significant changes in recent years.

CEO Michael Neidorff was the highest paid healthcare executive in the United States in 2020, earning nearly $25 million.

In December 2021, Politan Capital Management took a $900 million stake in Centene, which led to a leadership change.

CEO Michael Neidorff announced plans to retire by the end of 2022, following the agreement.

Sarah London was named chief executive officer of the company in March 2022, replacing Neidorff.

Centene Corporation has faced several controversies and issues over the years. In 2014, Fox News alleged that Superior HealthPlan of Texas denied coverage of an infant's surgery for brain cancer at Texas Children's Hospital.

A class action lawsuit in January 2018 accused Centene's Ambetter marketplace healthcare plans of misleading enrollees about plan benefits. This led to people having difficulty finding medical providers that accepted patients covered under Centene's policies.

Centene was also sued by two pension funds in December 2018, alleging that the company's acquisition of Health Net resulted in damages and exposed Centene to potential liability. The suit claimed that Centene concealed Health Net's $1B in past tax liabilities to California and was under investigation for Medicare fraud at the time of the acquisition.

Controversies have surrounded Centene, a health insurance company, and its subsidiaries in the past.

In 2014, Fox News reported that Superior HealthPlan of Texas, a joint-venture of Centene, denied coverage for an infant's brain cancer surgery at Texas Children's Hospital.

Three days after the report, Superior HealthPlan reversed its decision and covered the surgery.

A class action lawsuit was filed against Centene's Ambetter marketplace healthcare plans in January 2018, accusing them of misleading enrollees about plan benefits.

People who bought Centene's plans had difficulty finding medical providers that accepted patients covered under Centene's policies.

Centene was sued by two pension funds in December 2018, alleging that its acquisition of Health Net resulted in damages to Centene and exposed the company to potential liability.

The suit also claimed that Centene concealed Health Net's $1 billion in past tax liabilities to California and its investigation for Medicare fraud at the time of the acquisition.

Operose Health, a subsidiary of Centene, was accused of prioritizing profit over patient care by hiring cheaper physician associates instead of GPs.

In 2022, Operose Health had almost 600,000 NHS patients and was the largest supplier of GP services to the NHS.

The average number of full-time equivalent GPs per patient at Operose practices was about half the average in English practices.

Centene Corporation has been involved in several high-profile settlements in recent years. In April 2021, the company agreed to pay $97M to settle allegations that its subsidiary, Health Net Federal Services, had duplicated or inflated claims submitted to the Department of Veterans Affairs.

The company has also faced scrutiny over its pharmacy benefit manager subsidiary, Envolve. Between June 2021 and January 2022, Centene agreed to settlements with several states, including Ohio, Mississippi, Illinois, Arkansas, and New Hampshire, to resolve allegations of overpayments to the PBM from the states' Medicaid programs. These settlements have totaled over $191 million.

In December 2021, Centene agreed to pay $27.6M to Kansas to settle allegations that it had failed to disclose discounts and used other strategies to obtain more profit from Kansas' Medicaid program.

Here's a breakdown of the settlements:

Centene will also pay more than $14 million to Massachusetts's to resolve claims that it overcharged the state Medicaid program, MassHealth, millions of dollars for pharmacy benefits and services provided by subsidiary companies.

Health Net and Centene are now one company, combining their strengths to create a leading diversified health care services enterprise with over 10 million members in 23 states.

Their merger, completed on March 24, 2016, brings together two experienced health insurance providers, but don't worry, your benefits and premium administration don't change for 2016.

There's no need to change doctors or hospitals, as your clients' benefits remain the same as before. You don't need to make any changes or change providers, and if there are changes in the future, you'll be notified by letter.

The creation of a new company will bring new ways of doing business, but what's not going to change is Health Net's passion and commitment to providing quality, affordable health insurance coverage and service.

The merger will strengthen Health Net's products that serve commercial, Medicare, Medicaid, TRICARE, and Veterans Affairs members and beneficiaries, and maintain their commitment to the healthcare providers they currently work with.

Centene Corporation's Health Net offers a range of health insurance options.

Health Net is a subsidiary of Centene Corporation and provides health insurance services to individuals and families.

Banking & Financial Services plays a crucial role in managing health insurance premiums and claims payments.

Health Care & Hospitals work closely with Health Net to provide quality medical care to its members.

You can visit Health Net's website to learn more about their health insurance plans and services.