Centene Hasn't Fixed Obamacare Plan Doctor Shortage, State Says

(Bloomberg) -- Centene Corp. still hasn’t fixed problems in Washington that led the state to briefly bar the health insurer from selling Obamacare plans, the insurance regulator there said Thursday.

Washington will fine Centene’s Coordinated Care unit $100,000 for not complying with a December agreement to boost coverage of physicians such as anesthesiologists, Steve Valandra, deputy commissioner for public affairs at the state’s Office of the Insurance Commissioner, said by phone.

It’s a setback for the company’s business selling Affordable Care Act plans, which Centene has expanded in markets abandoned by other health insurers. Centene made the business a key part of its growth strategy after years of offering private-sector versions of Medicaid, the federal-state program for the poor.

Centene said it’s working with the state on fixing its doctor access shortage.

“We are disappointed that we have not achieved more at a faster pace,” Marcela Hawn, a spokeswoman for the company, said in an email. “We hold ourselves to high standards and we expect to have these issues corrected in very short order.”

Centene is also facing a lawsuit by customers, alleging the company misled customers in Washington about the number of doctors covered under its health plans. The company has said in response to the suit that its coverage is adequate.

Chief Executive Officer Michael Neidorff has used many of the strategies developed in its Medicaid business as Centene expands its Obamacare offerings, including limiting where its members can get care to hospitals and signing up doctors willing to accept lower reimbursement rates. While such strategies can lower patients’ premiums, they can pose a challenge when people seek care if there aren’t enough doctors or hospitals available.

The insurer in December had briefly been blocked by Washington regulators from selling 2018 health insurance plans. The halt was lifted when the company agreed to pay a $500,000 fine and take steps to ensure its customers have enough access to doctors and hospitals.

To contact the reporter on this story: Zachary Tracer in New York at ztracer1@bloomberg.net.

To contact the editors responsible for this story: Drew Armstrong at darmstrong17@bloomberg.net, Timothy Annett

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