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Dozens of Moda employees have lost their jobs after state regulators took control of the company’s individual health plans; insiders point to management decisions, as uncertainty remains for Moda and sister companies

Dozens of employees have been laid off from Moda Health and countless others are on tenterhooks as they await word from company officials and state regulators about their fate, according to insider accounts shared with The Lund Report.

Feb 5 2016
Medicaid payments – largely for care for CCO members -- double in some hospital categories, while private insurers pay a shrinking role across all hospital types.

Oregon’s hospitals are writing down far less unpaid revenue as “charity care,” as patients enroll in Medicaid-funded health plans and shift away from more traditional private insurance, according to a confidential report obtained by The Lund Report that provides a series of benchmarks for how dif

Jan 29 2016
Sen. Bates wants to give CCOs greater assurance that the state is making a long-term investment in the organizations. His bill would prevent the Oregon Health Authority from refusing to renew contracts with CCOs that are doing well. But CareOregon argued that the state must not let CCOs coast as they administer the Oregon Health Plan, and guaranteeing a contract removes incentives for good performance.

Sen. Alan Bates, D-Ashland, unveiled his latest version of a bill that would give clearer guidelines to the Oregon Health Authority as it works out new five-year contracts for the state’s coordinated care organizations.

A large number of homeless individuals have severe disabilities that make them eligible for federal support, but their conditions can deteriorate as they navigate the bureaucracy. HB 4042 would provide state funding to get these people into housing while the Department of Human Services helps them get approved federally.

The House Human Services Committee is making a bipartisan push to restore a general assistance program that will put up state funds to provide housing for people who are homeless and disabled while they await federal assistance.

The state has developed a plan that will pick up the healthcare tab for low-income Pacific Islanders who’ve been free to come to the United States because of military involvement around their home islands, but in a cruel injustice, cannot get access to Medicaid, unlike other legal longtime immigrants.

Oregon’s House Health Committee quickly and unanimously passed its first bill of the session on Monday, asking the state to set up a health insurance assistance program for a group of Pacific Islanders who are legal residents of the state but prohibited by federal law from receiving Medicaid.

Some tobacco vendors, including the Northwest Grocery Association, have pledged support for statewide licensing to avoid a patchwork of local ordinances, but licensing advocates are insisting on local control. Meanwhile, the House is debating a 50 percent retail tax on e-cigarettes and supplies.

Sen. Laurie Monnes Anderson, D-Gresham, and Sen. Elizabeth Steiner Hayward, D-Portland, appear determined to push through a state law requiring a license to sell tobacco and e-cigarettes to the public, but they face opposition from unlikely quarters.

R.J. Gillespie, M.D., and his team are working with parents at The Children’s Clinic to interrupt the cycle of adverse childhood experiences. Health System Transformation (HST) makes this project possible – and makes preventive and lifelong health priorities, by doing things differently and promoting local innovation.

It’s part of the Oregon Pediatric Improvement Partnership sponsored by Health Share of Oregon, a coordinated care organization serving Oregon Health Plan members in the Portland Metro Area.

Building on a bill from 2015 that gives pharmacists the ability to dispense birth control without a doctor’s prescription, HB 4124 allows them to bypass physicians when selling Naloxone, which is used to reverse the effects of an opiate or narcotic overdose, including from heroin and prescription drugs like Vicodin and Oxycontin.

Rep. Knute Buehler, R-Bend, is promoting a bill that would give pharmacists the ability to quickly dispense a life-saving drug for use in opiate overdoses without the prescription of one of his fellow physicians.

Now the partnership between OHSU and Moda could be at stake.

Moda Health’s spiral downward began long before the Oregon Insurance Division stepped into the picture earlier this week. The insurer actually started showing signs of distress last summer with mounting claims and few dollars to pay providers.

“Everyone was wondering when the Insurance Division was going to do something; these guys didn’t have any capital left. What’s going on now could close them down,” a confidential source told The Lund Report.

Oregon health officials are warning of unhealthy levels of heavy metals in Southeast Portland's air. They found high levels of cadmium and arsenic at a monitoring station near SE Powell Boulevard and SE 22nd Avenue.

In his lawsuit filed this week in federal court in Eugene, Roseburg pediatrician and former Architrave CEO Dr. Bob Dannenhoffer alleges the Architrave board voted to delay correcting overpayments to physicians -- a vote made in secret because CCOs are exempt from public meetings laws.

A lawsuit waged against an operator of Medicaid services for one of the state’s coordinated care organizations has produced damning allegations of Medicare and Medicaid fraud that were made in part because of the secret environment that state policymakers have created for the CCOs to manage care

She was the organization’s vice president of payer strategy, innovation and operations.

Cynthia Finter, senior vice president of payer strategy, innovation and operations, will be leaving PeaceHealth on Feb.

Right now Legacy Emanuel offers similar services on its campus and has for many years.

OHSU has announced its expansion of Doernbecher Children’s Hospital, making it the  “the first children’s hospital in the Pacific Northwest … . to offer comprehensive obstetric, neonatal and developmental medicine services in one location,” 

An ongoing controversy over generic equivalents to complex biological drugs is resurfacing in the 2016 session, as patient advocacy groups and drug companies try again to require pharmacists to take extra steps to notify prescribers of a substitution when they dispense something other than a brand-name biological drug.

Rep. Rob Nosse, D-Portland, is bringing back a bill that requires pharmacists to give extra notification to medication prescribers when the pharmacist dispenses a cheaper, biosimilar equivalent to a brand-name biological drug.

Reliant Behavioral Health was awarded the new contract without a competitive bidding process.

A multi-million contract awarded to Reliant Behavioral Health by the Department of Human Services is being called into question after the agency did not seek competitive bids.

We also have new jobs from Samaritan Health

If your company wants to reach a national audience to find the most qualified employees, you’ve come to the right place. Jobs posted on Health Hires now reach more than 10 million job seekers through the employment listing aggregator – the nation’s #2 ranked job board.

A group of four Democrats and one Republican discussed their policy ideas in Portland on Wednesday, but aside from a few modest proposals for the upcoming February session, goals from single-payer to improved consumer product safety and better Medicaid regulations may wait until 2017 and beyond.


Blues, Managed Care Plans, and Others Dominate Low-Cost Marketplace Offerings

The effects of several co-ops failing and United Healthcare (United) potentially exiting the marketplaces, could be overstated, according to a