Experience-Commitment-Results

KOL Sues Largest Health Insurer for Massive Healthcare Fraud

January 18: KOL has sued Centene,the largest carrier on the Health Insurance Marketplace and the largest Medicaid Managed Care Organization in the United States, for perpetrating a massive healthcare fraud, selling junk plans on state exchanges and misleading enrollees about the plan benefits. The lawsuit, which was immediately picked up by The New York Times, Bloomberg News, and many other media outlets, asserts that Centene knowingly sells health plans in markets where there are few if any participating doctors or hospitals, often falsifying its published lists of available in-network physicians in a given area. Centene markets these plans to price-sensitive buyers who receive government funds to purchase health insurance and the company then collects those funds in the form of taxpayer-funded reimbursements. The putative class action could come to have a million or more class members. For more information about the case, the New York Times article summarizing the case is foundĀ here and the complaint in the case can be readĀ here