Health Net

On July 2, 2015, Centene Corporation announced it would acquire Health Net for $6.8 billion. Upon completion, Health Net shareholders would own 29% of the combined company.[20] The acquisition was completed in March 2016 and the combined headquarters were established in St. Louis, Missouri.[20][21]

In 2018, Health Net in Arizona was merged into other Centene holdings to form Arizona Complete Health.[22] The following year, in September 2019, J. Brian Ternan was appointed CEO of Health Net.[23] In October, Health Net gave $75,000 in funding to California CareForce to support the free medical clinic.[24]

The Health Net Foundation was created in 2007 as the philanthropic arm of Health Net. It makes charitable contributions to organizations that promote wellness and preventive care, combat childhood obesity and support health programs for military families in communities where Health Net does business. Health Net launched its Foundation in September 2007 by providing a Three-Year $1.35 Million Grant to the American Heart Association.[31] The Health Net Foundation has provided other grants such as the $175,000 given to twelve California school-based health centers and community medical clinics to improve dental care and oral health.[32]

In addition to its Foundation, Health Net Federal Services has also participated in philanthropic causes. The division established a scholarship to be administered through National Military Family Association (NMFA) designating $150,000 to be awarded to military spouses in the TRICARE North Region.[33] Health Net Federal Services sponsors military-related sports-related events and veterans' sports clinics such as the National Veterans Golden Age Games in Honolulu[34] and the Veterans Wheelchair Games.

Since the 1980s, Health Net has been a sponsor of the March of Dimes' largest fundraising event, March for Babies. In 2008, more than 300 Health Net associates walked in March for Babies events across California contributing more than $325,000 through various fund-raising efforts.

For a number of years, Health Net sponsored the Health Net Pro Cycling Team, which now is sponsored by UnitedHealth Group. Health Net Pro Cycling Team Presented by Maxxis was run by Momentum Sports Group and based in the United States. Health Net won the team title in the 2004, 2005, 2006 and 2007 USA Cycling National Racing Calendar series competitions.

In 2007, Patsy Bates, a California beautician, sued Health Net claiming that they wrongfully terminated her care in the middle of her chemotherapy treatments. An internal company employee performance review made public during the lawsuit revealed that one of the company's managers had tied bonuses to the rescission rate for one analyst in charge of rescission reviews to discover reasons (such as application fraud) to discontinue coverage to enrollees. The company pointed out that Bates had withheld critical information - that she had damaged her heart by the use of fen-phen for diet purposes and stated an inaccurate weight; Bates replied that the insurance broker had filled out the form for her and she had been busy in her salon.[36] In February 2008, the court ruled in favor of Bates, ordering Health Net to pay $8.4 million in punitive damages and $750,000 for emotional distress.[37]

In November 2009, Connecticut attorney general Richard Blumenthal said Health Net lost the personal information of nearly 450,000 state residents and "failed to inform consumers for six months."[38][39] The data on the drive was unencrypted and included information about financial, health, and personal information.[39] It was discovered missing from the company's Connecticut office.[39] Health Net circulated a letter to customers in December 2009, including an offer of free credit protection from a company called Debix for two years.

On November 19, 2010, the Centers for Medicare and Medicaid Services (CMS) immediately suspended Health Net because the insurer improperly administered the Medicare drug benefit in contracts for its national prescription drug plan and local Medicare Advantage prescription drug plans.[40] The suspension required Health Net to cease marketing and enrollment of new members of all Health Net Medicare Advantage Prescription Drug (MAPD) and stand-alone Prescription Drug Plan (Part D) contracts, effective November 20, 2010. The sanctions relate to compliance with certain Part D requirements. The suspension did not affect existing Health Net Medicare enrollees.[41]

Although the company was allowed to resume marketing its Medicare products in August 2011, on January 6, 2012, the company agreed to sell its Medicare stand-alone Prescription Drug Plan (PDP) business to CVS Caremark Corp. (CVS) for about $160 million in cash. Health Net would continue to provide prescription drug plans as part of its Medicare Advantage plan offerings.[42]

On September 13, 2012, the Los Angeles County Medical Association joined two patients in suing Health Net for illegally denying medically necessary treatment, including cancer care. The lawsuit alleges that Health Net routinely and systematically denies claims based on its own definition of "medical necessity", violating well-established standards set forth by California law. According to the suit, Health Net is "the leader" in this calculated corporate practice to avoid paying claims.[43]

In September 2017, VA Inspector General Michael Missal issued a memorandum that listed four major “errors” that had resulted in excess payments to Health Net. These were:

• Duplicate Errors–Payments for medical claims that have been paid more than once;
• Other Health Insurance8 (OHI) Errors–Payments that were not adjusted for the amount OHI was responsible to pay the provider;
• Pass-Through Errors–Payments to reimburse the third-party administrator (TPA) that were more than the TPA paid the provider and;
• Rate Errors–Payments that did not use the appropriate Medicare or contract adjusted rate

Missal stated that duplicate payments alone accumulated over $50 million in overpayments to Health Net.[44]