Centen gave thousands to the campaigns of Georgia leaders as they faced Medicaid

A health insurance giant that has paid more than $485 million in legal settlements with states over pharmacy billing allegations is also a major donor to Republican Georgia Gov. Brian Kemp and Attorney General Chris Carr, according to campaign finance records.

St. Louis-based Centene Corp. said in a statement Monday that it is working with 13 states outside of Georgia and eight other states to settle Medicaid billing issues it has already agreed to pay. Until now in public contracts, state attorney general offices have been involved in determining contract terms and announcing settlement amounts.

According to Carr’s campaign filings, Sentine-related donations included spending on an event for him in late August. Carr’s campaign did not respond to a request for comment on the donation. Kemp’s campaign declined to comment.

Centene is the parent company of Peach State Health Plan, which provides managed-care services to nearly 1 million low-income Georgians enrolled in Medicaid and PeachCare for Kids. It is one of three companies that typically receive more than $4 billion a year from the state to operate public health insurance programs.

Centene has settled with 13 states over allegations that the company overbilled state Medicaid programs for prescription drug services. It has awarded at least $489 million in 10 states, with the remaining three yet to be publicly announced, KHN reported.

A spokeswoman for Carr’s office said Friday that the state is awaiting direction from the state Department of Community Health, or DCH, Georgia’s Medicaid agency, before reaching a settlement with Centene. “The state is aware of other settlements in other states involving Sentinel, and the Department of Law understands that DCH is conducting its review of relevant information,” Cara Richardson said. “Once DCH reaches a decision, the Legal Department stands ready to negotiate any potential settlement or provide legal representation in litigation.”

David Graves, a spokesman for the Community Health Department, told the Atlanta Journal-Constitution on Monday that the agency “can ensure that we are thoughtful and deliberate with our approach in a way that ensures Georgia taxpayers are best protected.” The governor’s office did not respond directly to questions about potential settlement discussions.

Centene is the national leader in Medicaid managed care, with more than 15 million members. The company earns about two-thirds of its revenue from Medicaid, which is funded jointly by state and federal taxpayers.

In many states, insurance companies like Centene manage Medicaid enrollees’ prescription drugs through what’s known as a pharmacy benefit manager. These benefit managers act as intermediaries between drug manufacturers and health insurers, and between health plans and pharmacies. In some cases, Centene acted as both the Medicaid managed-care provider and pharmacy benefit manager for those plans.

The company said in a statement Monday that it donates to candidates in both parties and generally supports incumbents: “As members of the health care community, we work with elected representatives to help improve quality of care and improve access to care. the communities we serve.”

Kemp’s re-election campaign has received more than $100,000 in contributions from Centene, its affiliates and its employees since 2018, according to state campaign records, including heavy donations after the first publicly announced settlements with Ohio and Mississippi in 2021.

Most of the $70,000 in Centene-related contributions to Carr’s campaign came from company executives, including $10,000 from CEO Sarah London. Carr’s campaign received $6,000 from Centene general counsel Chris Koster, a former Missouri attorney general who signed the pharmacy billing settlement on the company’s behalf.

Most of the Sentinel-related donations to Carr’s campaign occurred in late August, according to campaign records. This includes $3,097 for venue rental on Aug. 26 and $3,000 in catering costs on Aug. 24. The latter was provided by Kelly Layton, wife of Centen President Brent Layton, a former employee of the Georgia Department of Insurance. Five out-of-state Centene employees donated a total of $13,000 during that three-day period.

In previously announced settlements, Centene has not admitted wrongdoing. Centene set aside $1.25 billion to resolve pharmacy benefit manager settlements in “affected states” in 2021, according to a July filing with the U.S. Securities and Exchange Commission, which did not specify how many states were involved.

In January, Wade Rakes, president and CEO of Centen’s subsidiary Peach State Health Plan, warned community health officials that the company, after analyzing its pharmacy cost reporting, “may have a remittance obligation” to the state Medicaid program. Email obtained by KHN through a public records request.

William Perry, founder of Georgia Ethics Watchdogs, noted that state law does not prevent Kemp or Carr from accepting donations from companies like Centene that do business with the state. “They’ll sit there and say they didn’t do anything unethical under the law, but if you’re coming from a moral standpoint, it’s horrible,” he said. “It’s bad optics, and it makes me really sick.”

The campaign of Carr’s Democratic opponent in the November election, Jane Jordan, criticized the attorney general for accepting Centine’s contributions to her campaign. An affiliate of Centene donated $1,500 to Jordan in 2019, when he was running for re-election to the Georgia Senate, but the circle does not appear to have donated to his campaign.

“It’s another example of how Chris Carr prioritizes special interests over the people of Georgia, and the culture of corruption that characterizes the current office of the attorney general,” said Caroline Korba, a spokeswoman for Jordan. “We shouldn’t be trading attorneys general.”

An affiliate of Centene gave a total of $6,600 to Democrat Stacey Abrams, who is running against Kemp, in three separate donations since 2015, the latest in October 2018, during Abrams’ previous campaign for governor.

Maya T. Prabhu is a state government reporter for The Atlanta Journal-Constitution.

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