The Affordable Care Act expanded the state Medicaid program to 350,000 new members, but it didn’t pay providers as well as a separate reproductive health program for uninsured women, provoking concerns from Rep. Mitch Greenlick that the state may be inadvertently hurting Planned Parenthood and other women’s health providers.
A chief goal of the division is to create more transparency for consumers shopping on Cover Oregon or elsewhere to ensure they know what physicians and services they’ll be getting before they pick a health plan. The division also wants to give clear guidelines to insurers for compliance.
The American Association for the Study of Liver Diseases recommends that Sovaldi be used with patients with late-stage liver disease, but state bureaucrats were ready to block coverage for all patients because of the high price tag of the drug and a report from OHSU’s Center for Evidence-Based Policy that raised red flags about the drug’s studies, helping the state in its attempt to get out of paying for treatment.
Public-owned hospitals such as Bay Area, Blue Mountain, Coquille Valley, Curry General, Harney District, Lake District, Lower Umpqua, Pioneer Memorial, Southern Coos and Wallowa Memorial struggle to remain independent.
Among the private insurers, Regence BlueCross BlueShield is the lowest payer and reduced its rates over the past two year, while a new contract is under negotiation.
