A state investigation the following year found they charged taxpayers $224 million more for drugs than they paid the pharmacies that dispensed them. The state is also suing UnitedHealth's drug middleman on claims that it defrauded the Bureau of Workers' Compensation of $16 million. And Centene, the eighth-largest Medicare Advantage provider, last year agreed to pay Ohio $88.3 million to settle fraud claims with the Ohio Department of Medicaid and more than $1 billion to settle similar claims with 21 other states. Despite the lawsuits and controversies, the Medicaid department last year selected all three companies to receive contracts of more than $1 billion each. Mary Beth Donahue, president and CEO of the Better Medicare Alliance, in a response to the inspectors general's report said that her organization supports simplifying the prior-authorization process.