Centene CEO Michael Neidorff’s chief designer for the company, and its numerous health plan brands, is to keep the income stream going for as long as possible. Such is the motivation for the giant insurer’s participation in the lucrative Affordable Care Act (ACA) free exchange. Centene is killing it but to the detriment of consumers.
A lawsuit was filed against Centene in January 2018, and complainants from 15 states have accused the company of cheating them. At the center of the legal battle is Centene’s Ambetter brand, which according to the suit, ran in direct contradiction of the Obamacare principles. Sure, the Ambetter health plan was priced competitively but defaulted on the promised quality service.
In particular, the policyholders are accusing Centene of an insufficient network of medical professionals, which for many of the customers resulted in inaccessible doctors when needed. Also, the class suit revealed instances of additional medical bills that supposedly should have been covered by the Ambetter health plan.
Fictional Ambetter Offerings
Centene advertises all the Ambetter plans as comprehensive health care coverage. In whatever form, the company claims that the brand’s emphasis is the delivery of essential health services in a high-quality package. As the product came with a discount, thanks to the ACA subsidy, many customers took the bait and hoped Centene would not sully its reputation.
But to the policyholders’ horror, they soon found out that Ambetter was largely a work of fiction. As the legal complaint stated: “After purchasing an Ambetter insurance plan, they learned that the provider network Centene represented was available to Ambetter policyholders only in the material measure, if not largely, fictitious.”
The buyer’s dismay heightened when their probe exposed the fact that the Ambetter health plan merely padded its in-network of medical providers. It became apparent that the A-list also includes medical students, nurses, and other individuals not qualified to render any form of professional medical service. Long story short, Centene, through Ambetter, is merely milking the ACA. The health plan is nothing but a dismal form of service meant to exploit the system. For many of the disgruntled policyholders, it became clear that Centene is merely out to squeeze profits from the ACA exchange.
Centene’s Sorry History Of Misconducts
Exploiting the ACA and profiting from it is not new for Centene. The company had a previous legal tussle of the same kind in Washington State. In December 2017, 140 disappointed policyholders brought the insurer to court. It proved to be a losing battle for Centene, and the court ordered the insurer to pay $1.5 million, again for the crime of selling a product that they cannot deliver.
Likewise, Centene is entangled with legal problems in Arizona and California for its rejection and underpayment of benefit claims. Behavioral treatment centers and their thousands of patients are leading the fight against Centene. The complainants scored the Fortune 500 company for withholding coverage and toying with their businesses and lives.
