August 08, 2022
NONA TEPPER
A new lawsuit alleges Centene took advantage of enrollee churn between Medicaid and health insurance exchange policies to defraud the federal government and dupe consumers.
The plaintiffs claim the insurer acquired local Medicaid carriers to enroll people into its Ambetter exchange products when they lose eligibility for the low-income health program. Centene then named its exchange policies after the Medicaid plans to mislead members into thinking they were enrolling in coverage with similar benefits, the lawsuit alleges. For example: the insurer named its Florida exchange plan “Ambetter from Sunshine Health” after its Medicaid managed-care insurer, “Sunshine State Health Plan,” the complaint says. Six Centene policyholders represented by Wexler Boley & Elgersma filed the suit in U.S. District Court for the Northern District of Illinois Friday.
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