DES MOINES, Iowa (AP) — A newspaper investigation finds that a company chosen to manage Iowa’s newly privatized Medicaid system has a history of alleged mismanagement and at least $23 million in fines in more than a dozen states. The Des Moines Register reports that Iowa Total Care, a Centene subsidiary, was awarded a state Medicaid contract in May despite scoring nearly 14 points lower on its evaluation than when Iowa rejected its application in 2015.

The newspaper found that at least 300 sanctions were levied against Centene and its subsidiaries since 2013, including failing to promptly pay medical claims. A federal lawsuit filed this year also alleges Centene has failed to provide adequate access to doctors in at least 15 states. Centene spokeswoman Marcela Hawn says the company knows it must earn Iowa residents’ trust and develop partnerships with providers and the community.