Summary
Centene Corporation (CNC) has filed an 8-K detailing a material definitive agreement through an amendment to its managed care contract with the Texas Health & Human Services Commission. This amendment, effective March 1, 2012, is crucial as it establishes the capitation rates for the STAR, STAR+PLUS, and CHIP programs in Texas for the period of March 1, 2012, through August 31, 2012. This agreement directly impacts Centene's revenue and operational planning within a significant state market.
Key Highlights
- 1Centene's subsidiary, Superior HealthPlan, Inc., executed an amendment to its Texas Health & Human Services Commission Uniform Managed Care Contract.
- 2The amendment establishes capitation rates for the STAR, STAR+PLUS, and CHIP programs in Texas.
- 3The rate period covered by the amendment is March 1, 2012, through August 31, 2012.
- 4Centene's operations in Texas expanded significantly effective March 1, 2012.
- 5New service areas added include the Hidalgo Service Area and Medicaid Rural Service Areas (West Texas, Central Texas, North-East Texas).
- 6Centene also added STAR+PLUS in the Lubbock Service Area.
- 7The expansion includes the management of outpatient pharmacy benefits across all service areas and products, and inpatient facility services for the STAR+PLUS program.
Frequently Asked Questions
The primary purpose of this 8-K filing is to announce the execution of an amendment to Centene's managed care contract with the Texas Health & Human Services Commission. This amendment is material because it establishes the capitation rates for key state health programs (STAR, STAR+PLUS, CHIP) in Texas for a defined period.
The amendment, along with prior operational activities, signifies a significant expansion of Centene's presence in Texas. It includes new service areas, the addition of the STAR+PLUS program in Lubbock, and the assumption of responsibility for outpatient pharmacy benefits and STAR+PLUS inpatient facility services.
The capitation rates are the per-member, per-month payments Centene will receive from the state for providing services. Establishing these rates for March 1, 2012, through August 31, 2012, provides Centene with revenue visibility and predictability for this period, which is critical for financial planning and performance assessment.
The contract amendment specifically addresses capitation rates for the STAR program, the STAR+PLUS program, and the CHIP program in the State of Texas.