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Lawsuit targets Centene’s narrow approach to ACA plans



Centene Corp. rushed to fill the void when many bigger insurers gave up on the Affordable Care Act, but a lawsuit alleges that the fast-growing insurer’s coverage is less robust than advertised.

The Clayton-based company misled customers about the number of doctors covered under its health plans, offering individuals who bought ACA coverage skimpier insurance than they signed up for, according to the federal suit filed in Washington state on Thursday.

Customers in Centene’s ACA plans had difficulty finding care providers who’d accept their insurance, the suit says, and discovered that even doctors listed by Centene as taking its coverage often didn’t.

The suit, filed on behalf of two Centene customers, seeks class-action status to represent all customers of the insurer’s ACA plans, which are sold under the Ambetter brand.

Centene, which specializes in covering low-income individuals, has been expanding in the ACA’s marketplaces even as rivals retreat. That has left consumers in some parts of the country with little choice of plans; in many counties where it expanded, Centene is the only insurer offering coverage under the health law. The company, based in St. Louis, now has more than 1.4 million customers in its ACA plans across 15 states, placing it among the largest insurers in the program.

The scrutiny of the company’s provider networks could limit its expansion plans or reduce profits.

Read more: Bloomberg

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