Centene donated thousands to the campaigns of Georgia leaders while facing Medicaid overbilling issues

Centene donated thousands to the campaigns of Georgia leaders while facing Medicaid overbilling issues

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

St. Louis-based Centene Corp. said in a statement Monday that it is working to resolve Medicaid billing issues with Georgia and eight other states, beyond the 13 states it has already agreed to. In previous public contracts, the public prosecutor's offices were involved in drafting the contracts and announced the settlement amounts.

According to Carr's campaign filings, Centene-related donations included expenses for an event for him in late August. Carr's campaign did not respond to requests for comment about the donations. Kemp's campaign declined to comment.

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

Centene has settled with 13 states over allegations that the conglomerate overcharged state Medicaid programs for prescription drug services. It paid in total at least $489 million in 10 states, although the other three have not yet been publicly announced, KHN has reported.

A spokesman for Carr's office said Friday that it is awaiting guidance from the state Department of Community Health, or DCH, Georgia's Medicaid agency, before the state pursues a settlement with Centene. “The state is aware of other settlements in other states involving Centene, and the Legal Department understands that DCH is conducting a review of its relevant information,” Kara Richardson said. “Once DCH has reached a decision, its legal department stands ready to provide legal representation in any possible settlement negotiations or litigation.”

A spokesman for the Community Health Department, David Graves, told The Atlanta Journal-Constitution on Monday that the agency "can confirm that we will be thoughtful and intentional in our approach to ensure Georgia taxpayers are best protected." The governor's office did not immediately respond to questions about possible settlement negotiations.

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

In many states, insurance companies like Centene also manage Medicaid members' prescription drugs through a so-called pharmacy benefit manager. These benefit managers act as middlemen between drug manufacturers and health insurance companies and as an intermediary between health insurance companies and pharmacies. In some cases, Centene acted as both a Medicaid managed care provider and a pharmacy benefit manager for these plans.

The company said in a statement Monday that it donates to candidates of both parties and generally supports incumbents: "As a member of the healthcare community, we work with elected officials to help improve the quality of care and access to services in the communities we serve."

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

Most of the more than $70,000 in Centene-related donations to Carr's campaign this year came from company executives, including $10,000 from CEO Sarah London. Carr's campaign also received $6,000 from Centene general counsel Chris Koster, a former Missouri attorney general who signed pharmacy billing agreements on behalf of the company.

A majority of Centene-related donations to Carr's campaign occurred in late August, according to campaign filings. They include $3,097 for venue rental on August 26 and catering costs of $3,000 on August 24. The latter was paid for by Kelly Layton, the wife of Centene President Brent Layton, a former employee of the Georgia Department of Insurance. Five Centene employees from other states donated a total of $13,000 during the three days.

Centene has not admitted any wrongdoing in previously announced settlements. According to a report, Centene committed $1.25 billion in 2021 to resolve pharmacy benefit manager settlements in “affected states.” Submission in July with the US Securities and Exchange Commission, which did not specify how many states were involved.

In January, Wade Rakes, president and CEO of Centene subsidiary Peach State Health Plan, warned Community Health officials that the company "may have a referral obligation" to the state's Medicaid program after an analysis of its pharmacy cost reporting an email received from KHN through a public records request.

William Perry, founder of Georgia Ethics Watchdogs, pointed out that there is nothing in state law that prevents 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 come from an ethical-moral position, it's terrible," he said. “It’s bad optics and it really makes me sick.”

The campaign of Carr's Democratic opponent in the November election, Jen Jordan, criticized the attorney general for accepting the Centene donations to his campaign. A Centene subsidiary donated $1,500 to Jordan in 2019 when she was running for re-election to the Georgia Senate, but the conglomerate appears to have donated nothing to her campaign this cycle.

“This is another example of Chris Carr putting special interests ahead of the people of Georgia and the culture of corruption that characterizes the current attorney general’s office,” said Caroline Korba, a spokeswoman for Jordan. “Our attorney general should not be bought and sold.”

A Centene affiliate gave Stacey Abrams, the Democrat running against Kemp, a total of $6,600 in three separate donations since 2015, the most recent coming 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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