The Oregon Health Authority’s Medicaid renewal plan is marooning recipients for weeks or months in a separate system outside the state’s coordinated care organizations, limiting members access to care and keeping funds away from the local CCOs, in an arrangement that is drawing criticism from sta
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As they jump through a difficult re-enrollment process, 147,000 Medicaid members have been caught outside coordinated care organizations with little access to care, which could cause the state and CCOs to lose $200 million per year in Medicaid funding, mostly from federal sources.
May 22 2017
Proposals submitted this week would have rates climb as much as 20.7 percent on the individual marketplace, with nearly all silver-level plans now costing over $400 per month. Small businesses face smaller increases of 2 percent to 8.5 percent, with most small group plans still below $400 per member per month.
Uncertainty in the insurance industry is again pushing up the cost of health coverage for individuals and small businesses, according to rate requests submitted to the Oregon Department of Consumer and Business Services this week.
May 17 2017
 Oregon Health Authority Director Lynne Saxton said the state does have approval of the federal government for its haphazard re-enrollment process, which should be finished by the end of summer. But new deadlines from the governor merely affirm the schedule Saxton has outlined. Democratic Gov. May 23 2017 |
House Joint Resolution 32 would send voters voters a measure limiting donations from publicly financed companies to political candidates to $500 per politician. The measure was put forward the same day that Greenlick’s HB 2122 was pulled from the House floor under pressure from Medicaid providers, who have spent heavily on legislative campaigns. Rep. Mitch Greenlick, D-Portland, has drafted a ballot referendum that would limit political donations to $500 from any organization that gets more than half of its funding from public sources. May 23 2017 |
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The decision allows FamilyCare to move ahead with its claims regarding the inequitable and actuarially unsound rate setting process that has resulted in three consecutive years of operating deficits for the Portland-based Coordinated Care Organization.
A Marion County judge has denied the Oregon Health Authority’s motions to dismiss the 2017 lawsuit filed by FamilyCare Health against OHA. May 23 2017 |
Only 15 percent of Oregon Health Plan income-based members have seamless coverage at renewal time. Rep. Cedric Hayden wants to pull enrollment from OHA and give it to DHS, and require that lapsed members be put immediately back into the CCO that was serving them. Medicaid members must renew each year. May 22 2017 |
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Hospitals should use their profits to supply housing, a 15-year veteran of the street newspaper movement told more than 100 people who attended an OHSU School of Public Health event, and some 3,000 others who watched online. Last February, Cameron Foster and her four daughters found themselves homeless. A shelter for those fleeing domestic violence served as housing for the first three months. May 19 2017 |
Don’t miss this opportunity to learn how mental health and addiction funding could be impacted if the Affordable Care Act is repealed at our May 31 breakfast forum. Even though the effort to repeal and replace the Affordable Care Act still needs to make its way through the U.S. Senate, the final version could have a huge impact on mental health and addiction services which are considered essential benefits that health insurers must cover. May 19 2017 |
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Portland, Ore. (May 22, 2017) After nine years of leading Legacy Health through the uncharted waters of health care reform; record organizational growth; and the early adoption of many health care innovations, George J. May 22 2017 |
The Justice Department on Tuesday accused giant insurer UnitedHealth Group of overcharging the federal government by more than $1 billion through its Medicare Advantage plans. May 19 2017 |
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Dr. Bruce Carlson runs a family practice clinic in eastern Oregon. He is looking for a part-time MD or DO to join his team out of Pendleton and Hermiston. May 19 2017 |
An audit by the Oregon Secretary of State’s office found that health officials may not have adequately checked to see if people met Medicaid requirements before enrolling them in health plans. But the health authority says the audit missed key context, including a federal waiver governing Medicaid renewals. Two powerful Oregon agencies are butting heads over whether the state is using federal Medicaid dollars correctly. May 17 2017 |
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A bill passed the House unanimously in April to give dental care providers a seat on the governance boards of CCOs, to help improve Medicaid dental care. The bill had been amended to allow CCOs to make the appointment, after DCOs nominate, but the CCOs are now fighting the bill in the Senate. Lobbyists from coordinated care organizations successfully derailed new transparency requirements last week and now the clout-heavy organizations are aiming to kill a bill in May 17 2017 |
In 2014, estimates suggest Oregon saved $13.7 million on fee-for-service Medicaid prescriptions because of its medical marijuana program. States like Oregon that have legalized medical marijuana are saving a significant amount of money on Medicaid and Medicare prescription costs, according to a new study released in the April edition of Health Affairs. May 17 2017 |
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A leading researcher on the link between opioid use and marijuana will travel from Colorado to speak at the event. An OHSU expert on substance abuse disorders will also be on the panel. One of the nation’s leading research on the health effects of marijuana will be presenting in Portland at an upcoming Oregon Health Forum breakfast. May 9 2017 |
Advocates are trying to bring a tobacco license registration back to SB 235, after that provision was gutted earlier. They hope to institute new regulations aimed at reducing youth tobacco use, with fees to pay for the program. The Oregon Nurses Association and the Coalition of Local Health Officials have reintroduced an amendment to Senate Bill 235 that would put in place a statewide tobacco license registration, while still allowing counties and cities free rein to impose additional fees and regulations on tobacco ven May 17 2017 |
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Marylhurst University has been offering academic programs in art therapy for 30 years, but without a license, anyone can claim to be an art therapist, even people with little to no hands-on training in the therapeutic practice. After a lively debate, the Senate voted 23-7 on Monday to approve a bill that will license art therapists, which will sanction the integrity of art therapy and ward off unqualified practitioners from using the term. May 17 2017 |
Pressure from coordinated care organizations forced Democrats to drop requirements that the opaque Medicaid insurance providers meet openly. But HB 2122 should still stop out-of-state corporations from taking over the state Medicaid system and siphoning healthcare dollars for the poor for Wall Street portfolios. Rep. Mitch Greenlick’s attempt to protect and improve the community-based focus of the state Medicaid program has survived the House Rules Committee on a party-line 5-4 vote and will head to the House floor for a vote next week. May 12 2017 |