This raised conflict of interest concerns for DHCS since Centene operates managed care plans and pharmacies that participate in Medi-Cal. After originally delaying implementation to April 1, 2021, DHCS delayed the start date indefinitely in February after receiving conflict avoidance protocols from Magellan.
After reviewing these protocols, DHCS deemed Magellan’s plan met the two main conflict avoidance requirements the department had identified: that MMA can’t share proprietary data on members with Centene and that Centene can’t be involved in prior authorization or claim approvals and payments to its six specialty pharmacies that participate in Medi-Cal.
The department also summarized the main features of the Conflict Avoidance Plan as follows:
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