WellCare Selected to Participate in CMS Senior Savings Model

·9 min read

Program Aims to Lower Out-of-Pocket Costs for Insulin, Improve Health Outcomes for Medicare Beneficiaries

ST. LOUIS and TAMPA, Fla., Oct. 26, 2020 /PRNewswire/ -- WellCare, a wholly owned subsidiary of Centene Corporation, announced today it was selected by the Centers for Medicare & Medicaid Services (CMS) to participate in the Part D Senior Savings Model – a program which aims to reduce Medicare enrollees' monthly out-of-pocket costs for insulin.

(PRNewsfoto/WellCare Health Plans, Inc.)
(PRNewsfoto/WellCare Health Plans, Inc.)

WellCare volunteered to participate in the five-year model, which aims to lower and stabilize costs by capping beneficiaries' copays at $35 or less for a 30-day supply of insulin. The program begins on Jan. 1, 2021.

"We are pleased to have been selected to participate in this innovative pilot program and look forward to working with our government partners and various leaders from across the industry to bring high-quality, more affordable care and medications to our members living with diabetes," said Laura Hungiville, Chief Pharmacy Officer, Centene Corporation.

It is estimated that one in three Medicare beneficiaries has diabetes, and 3.3 million require insulin. Additionally, one in four people on insulin report they have reduced use of the drug due to its cost. This disparity led WellCare to participate in the program.

WellCare is offering the new benefit on 102 standalone Prescription Drug Plans and on select Medicare Advantage plans across the country during the Annual Enrollment Period running now through Dec. 7, 2020. WellCare Prescription Drug Plans offer some of the lowest premiums across the country and include robust formulary and network pharmacy options to meet a variety of needs.

To learn more, visit www.PDPWellCare.com or call 1-844-942-0034.

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The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document

WellCare Health Plans, Inc. is an HMO, PPO, PDP, PFFS plan with a Medicare contract and is an approved Part D Sponsor. Enrollment in our plans depends on contract renewal.

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About WellCare
WellCare provides government-sponsored managed care services to families, children, seniors, and individuals with complex medical needs primarily through Medicaid, Medicare Advantage, and Medicare Prescription Drug Plans. WellCare is a wholly owned subsidiary of Centene Corporation, a leading multi-national healthcare enterprise committed to helping people live healthier lives. For more information about WellCare, please visit www.wellcare.com.

About Centene Corporation
Centene Corporation, a Fortune 50 company, is a leading multi-national healthcare enterprise that is committed to helping people live healthier lives. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Centene offers affordable and high-quality products to nearly 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in correctional facilities. The Company also serves several international markets, and contracts with other healthcare and commercial organizations to provide a variety of specialty services focused on treating the whole person. Centene focuses on long-term growth and the development of its people, systems and capabilities so that it can better serve its members, providers, local communities, and government partners.

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All statements, other than statements of current or historical fact, contained in this communication are forward-looking statements. Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "intend," "seek," "target," "goal," "may," "will," "would," "could," "should," "can," "continue" and other similar words or expressions (and the negative thereof). Centene (the "Company", "our", or "we") intends such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, and we are including this statement for purposes of complying with these safe-harbor provisions. 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You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables and events including but not limited to: the impact of COVID-19 on global markets, economic conditions, the healthcare industry and Centene's results of operations, which is unknown, and the response by governments and other third parties; uncertainty as to Centene's expected financial performance during the period of integration of the WellCare Acquisition; the possibility that the expected synergies and value creation from the WellCare Acquisition will not be realized, or will not be realized within the expected time period; the risk that unexpected costs will be incurred in connection with the integration of the WellCare Acquisition or that the integration of WellCare will be more difficult or time consuming than expected; unexpected costs, charges or expenses resulting from the WellCare Acquisition; the inability to retain key personnel; disruption from the integration of the WellCare Acquisition, including potential adverse reactions or changes to business relationships with customers, employees, suppliers or regulators, making it more difficult to maintain business and operational relationships; the risk that Centene may not be able to effectively manage its expanded operations; Centene's ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical utilization rates due to the impact of COVID-19; competition; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies, and advances in medicine; increased healthcare costs; changes in economic, political or market conditions; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act ("ACA") and the Health Care and Education Affordability Reconciliation Act, collectively referred to as the ACA and any regulations enacted thereunder that may result from changing political conditions or judicial actions, including the ultimate outcome in "Texas v. United States of America" regarding the constitutionality of the ACA; rate cuts or other payment reductions or delays by governmental payors and other risks and uncertainties affecting Centene's government businesses; Centene's ability to adequately price products on the Health Insurance Marketplaces and other commercial and Medicare products; tax matters; disasters or major epidemics; the outcome of legal and regulatory proceedings; changes in expected contract start dates; provider, state, federal, foreign and other contract changes and timing of regulatory approval of contracts; the expiration, suspension, or termination of Centene's contracts with federal or state governments (including but not limited to Medicaid, Medicare, TRICARE or other customers); the difficulty of predicting the timing or outcome of pending or future litigation or government investigations; challenges to Centene's contract awards; cyber-attacks or other privacy or data security incidents; the possibility that the expected synergies and value creation from acquired businesses, including businesses Centene may acquire in the future, will not be realized, or will not be realized within the expected time period; the exertion of management's time and Centene's resources, and other expenses incurred and business changes required in connection with complying with the undertakings in connection with any regulatory, governmental or third party consents or approvals for acquisitions; disruption caused by significant completed and pending acquisitions, including, among others, the WellCare Acquisition, making it more difficult to maintain business and operational relationships; the risk that unexpected costs will be incurred in connection with the completion and/or integration of acquisition transactions; changes in expected closing dates, estimated purchase price and accretion for acquisitions; the risk that acquired businesses will not be integrated successfully; restrictions and limitations in connection with Centene's indebtedness; Centene's ability to maintain or achieve improvement in the Centers for Medicare and Medicaid Services ("CMS") Star ratings and maintain or achieve improvement in other quality scores in each case that can impact revenue and future growth; availability of debt and equity financing, on terms that are favorable to us; inflation; foreign currency fluctuations and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission. This list of important factors is not intended to be exhaustive. Centene discusses certain of these matters more fully, as well as certain other factors that may affect Centene's business operations, financial condition and results of operations, in Centene's filings with the Securities and Exchange Commission ("SEC"), including Centene's annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Due to these important factors and risks, Centene cannot give assurances with respect to Centene's future performance, including without limitation Centene's ability to maintain adequate premium levels or Centene's ability to control its future medical and selling, general and administrative costs.

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