Centene Corp. misled customers about the number of doctorscovered under its health plans, offering individuals who boughtObamacare plans far skimpier coverage than they signed up for,according to a lawsuit filed on Thursday.

Customers in Centene’s Affordable Care Act insurance plans haddifficulty finding care providers who’d accept their insurance, and found that evendoctors listed by the insurer as taking the coverage often didn’t,according to the federal suit filed in Washington State onThursday.

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

“Members have difficulty finding -- and in many cases cannotfind -- medical providers who will accept Ambetter insurance,”according to the lawsuit. “After purchasing an Ambetter insuranceplan, they learn that the provider network Centene represented wasavailable to Ambetter policyholders was in material measure, if notlargely, fictitious.”

Centene, which specializes in covering low-income individuals,has been expanding in the Affordable Care Act’s marketplaces evenas rivals retreat. The company, based in St. Louis, now has morethan 1.4 million customers in its ACA plans across 15 states,placing it among the largest health insurers in the program.

Centene Chief Executive Officer Michael Neidorff built up theinsurer by covering poor, disabled and pregnant individuals instate Medicaid programs. The company has used many of the skillsand strategies developed in that program in its ACA plans,including limiting where its members can get care to hospitals anddoctors willing to accept lower reimbursement rates.

The scrutiny of the company’s provider networks could limit itsexpansion plans or reduce profits. Washington State’s insuranceregulator briefly forced Centene to halt sales late last year afterfinding the company failed to include enough care providers in itsnetwork. The insurer has to fix the problem and submit to outsidemonitoring. Centene is also seeking to expand into New York byacquiring the health insurer Fidelis Care.

The case is Harvey v. Centene Corp., 18-cv-00012, U.S.District Court, Eastern District of Washington (Spokane).

— With assistance by Andrew M Harris

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