Founded as a single health plan in 1984, Centene Corporation has developed into a diversified, multinational healthcare corporation. It provides a variety of services to government-sponsored healthcare programs, focusing on under-insured and uninsured individuals. Centene is known as an expert in Medicaid managed care, specifically serving people receiving benefits under the State Children’s Health Insurance Program (CHIP), the Aged, Blind, and Disabled (ABD) program, Foster Care, and Long Term Care (LTC), in addition to Medicare (Special Needs Plans). Centene also contracts with local healthcare and commercial organizations to provide specialty services: behavioral health management, care management software, correctional health care, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.
Centene has grown rapidly through a strategy of acquisitions and mergers. On July 2, 2015, Centene announced that it would acquire HealthNet in a cash-and-stock deal valued at $6.3 billion. This deal will make Centene one of the largest Medicaid managed-care organizations in the country. The deal will close by early 2016.
In 2014, Centene had advanced its ranking position to number 186 in the Fortune 500. Its consolidated financial statement indicates revenues of $15.667 billion, with net earnings for that year at $271 million. The company is projecting $21 billion in revenue for 2015. Centene Corporation has not issued any cash dividends to its stockholders. Because it files a consolidated financial statement with the SEC, without detailing revenues from its subsidiaries, it is not possible to determine what percentage of Centene’s revenues are attributable to prison health care.
Centene Corporation and MHM Services, Inc. formed a joint venture named Centurion Managed Care, LLC, which began operations in 2013. As of August 2015, Centurion has won contracts to provide medical and mental health care services to five state prison systems. These contracts will be administered through subsidiaries in each state. The Massachusetts contract began July 1, 2013, and will continue for 5 years with a total cost of $500 million. The Minnesota contract took effect on January 1, 2014, for 2 years at a total cost of $67.5 million. The contract with Tennessee began on January 1, 2014, with a total cost of $232 million for 3 years. In Vermont, the Centurion contract began February 1, 2015, and will continue for 3 years at an annual cost of $19.5 million. The Mississippi contract began July 1, 2015, and will continue for 3 years and a total cost of $142.9 million.
Despite the fact that Centurion has only been operating a brief time in the correctional health industry, serious complaints have already been lodged about its medical treatment of prisoners. In May of 2015, the International Humanitarian Law Institute filed a lawsuit (Ligons et al. v. MN Dept. of Corrections et al.) on behalf of 2 men and a potential class of 1500 people in the Minnesota prison system who are infected with Hepatitis C. The Minnesota Department of Corrections and Centurion Managed Care are named as plaintiffs in the lawsuit, for refusing Minnesota prisoners access to the latest, most effective Hepatitis C treatments. These treatments (Sovaldi, Olysio, Harvoni, and Viekera-Pak) are now the community standard of care, and have been adopted by the U.S. Bureau of Prisons, Veterans’ Administration, Centers for Disease Control, Medicaid and Medicare, National Health Service, and even Minnesota Department of Human Services.
On June 10, 2015, a similar lawsuit (Paszko v. O’Brien) was filed against the Massachusetts Department of Corrections and the Massachusetts Partnership for Correctional HealthCare, LLC (a Centurion subsidiary). The lawsuit notes that “over 1,500 state prisoners in Massachusetts have Hepatitis C, but as of the present time only three are being treated for it.” This suit seeks class-action status and injunctive relief for Hepatitis C screening and adequate treatment for prisoners who are HCV-positive.