Court: United States District Court, Northern District of Illinois
Havrilla, et al. v. Centene Corp., et al., Case No. 22-cv-04126
WBE and co-counsel brought this class action against Centene Corporation and two of its subsidiaries. Plaintiffs allege that Centene Corporation—currently the largest provider of health-insurance plans sold on the online exchanges established by the Affordable Care Act (ACA)—and its subsidiaries engaged in an illegal multi-billion-dollar scheme to defraud consumers, taxpayers, and government entities through the company’s Ambetter branded health-insurance plans in violation of the Racketeer Influenced and Corrupt Organizations Act (RICO).
The lawsuit alleges that, among other things, Centene overcharged predominantly low-income individuals across 26 states—and the federal government, which provides substantial subsidies—by marketing and selling fraudulent Ambetter health-insurance policies that do not provide Ambetter’s advertised provider coverage. In addition to the hundreds of millions of dollars overcharged to consumers, the lawsuit highlights the harm incurred by taxpayers and government entities through federally subsidized cost-sharing. In detailing the fraud perpetuated against the federal government, the lawsuit alleges that by knowingly sending these fraudulent policy documents to customers physically and electronically, Centene and its subsidiaries committed millions of violations of the mail and wire fraud statutes that constitute a pattern of racketeering activity under federal RICO laws.
On Thursday, May 2, 2024, U.S. District Court Judge Nancy L. Maldonado ruled that Plaintiffs could proceed on the majority of their claims against Centene Corporation and two of its subsidiaries, Centene Management Company, LLC, and Celtic Insurance Company. With the remainder of Defendants’ motion to dismiss having been denied, Plaintiffs can now move forward on their federal RICO claim as well as their claims under 11 states’ consumer-protection statutes. Discovery in the case is currently ongoing.
To read a copy of the complaint, click here.