Centene Resumes Washington State Sales After Agreeing to Provider Network Fixes

December 15, 2017 at 11:18 AM
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Centene Corp. will be allowed to resume selling health insurance plans in Washington state three days after regulators ordered a halt, saying the company failed to cover enough doctors and other care providers.

Centene agreed to pay a $500,000 fine, submit to outside monitoring, and take steps to ensure its customers have enough access to doctors and hospitals. If the company doesn't comply, it could end up owing another $1 million fine.

""They understand the seriousness of the violations and made a commitment today to correct them," Mike Kreidler, Washington's insurance commissioner, said in a statement. "We will be monitoring the company very closely to make sure that policyholders are protected and they receive the coverage they've paid for."

Despite the resumption, the brief regulatory hiccup shines an unfavorable light on Centene's strategy. The insurer, which operates under brands including Ambetter, has rapidly expanded sales of Affordable Care Act public exchange plans, offering consumers a limited choice of doctors and hospitals in exchange for a lower up-front premium. Bloomberg found earlier this year that some Centene customers faced difficulties visiting their preferred hospitals and doctors in the insurer's Affordable Care Act plans.

Shares of the St. Louis-based company fell 4.2% to $94.86 at the close in New York.

In a Dec. 12 order, Washington's insurance commissioner told Coordinated Care Corp., a Centene unit, to stop selling 2018 plans. The regulator said it intervened after receiving about 100 consumer complaints about a lack of doctors in Centene's network, and that the insurer had failed to fix the problems.

"We are committed to address known issues in our network in select regions of the state, and we have taken actions to ensure our members have access to these services," Centene said in a statement. "Ambetter from Coordinated Care continues to grow its network and add providers."

In Washington's Obamacare market, Friday is the last day to enroll in coverage that starts on Jan. 1. The final deadline for 2018 plans that start later in the year is Jan. 15.

Centene's plans remained available on the state's insurance-shopping website throughout the halt. Steve Valandra, a spokesman for Washington's insurance regulator, said people who signed up during the sales interruption would be allowed to enroll in plans.

A Centene representative had no immediate comment. In Washington, the company received a one-star rating, out of five possible stars, on a ranking of customer experience.

With assistance from Hannah Recht and Bryan Gruley.


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