Allen Starts at OHA, Bringing Insurance Commissioner Laura Cali Robison to Help

The Oregon Health Authority begins the Labor Day weekend with a changing of the guard as Lynne Saxton, Mark Fairbanks, Dr. Varsha Chauhan and BethAnne Darby leave while a new team from the Department of Consumer & Business Services takes over, along with Gov. Brown’s top health advisor, Jeremy Vandehey.

Outgoing Department of Consumer & Business Services Director Pat Allen will be cleaning house at the Oregon Health Authority and bringing some of his top lieutenants with him as he takes over as interim director on Friday.

In an email given to The Lund Report, Allen said the state insurance commissioner, Laura Cali Robison will step down permanently from her position and become the chief financial officer at the Oregon Health Authority, pushing aside Mark Fairbanks, who has also served as the chairman of the Public Employees Benefit Board.

Allen was gracious and magnanimous to the outgoing Oregon Health Authority team, acknowledging their successes and omitting their failings, which culminated in the forced resignation of Director Lynne Saxton in early August.

“[Saxton] oversaw renewal of Oregon’s Medicaid waiver, stabilized Medicaid funding, and put Medicaid eligibility processing back on its feet after the Cover Oregon failure,” Allen wrote in a memo to his staff.. “She led major reforms in Oregon’s behavioral health system which will remain a priority for OHA. And she responded to the tragic events at Umpqua Community College and the Portland air toxics crisis with a level of concern and responsiveness that embodies public service.”

But the leadership changes made clear that Allen intends to bring in the A-team from his own agency, one of the best run, to the OHA, which has been one of the most dysfunctional. “He’s building a powerful team at OHA,” said Rep. Mitch Greenlick, D-Portland, the chairman of the House Health Committee, whom Allen had briefed on his moves.

Despite Saxton’s efforts to mop up the Cover Oregon/ Oracle mess, the agency has still struggled mightily both to ensure that everyone on the Oregon Health Plan is eligible and that everyone who is eligible is getting access to healthcare.

On her last day, OHA spokesman Robb Cowie announced that the agency had completed the backlog of eligibility determinations, certifying the final 115,000 applications for approval and booting 23,000 people who had lost eligibility. The applications will now be reappraised on a rotating basis annually.

The problems at the massive state agency predate Saxton; former Director Bruce Goldberg was also forced to resign for his role in the mismanagement of Cover Oregon, the failed insurance exchange that was never able to enroll a single person online.

Cali Robison has served as insurance commissioner since 2013, presiding over the volatile changes Obamacare has brought to the health insurance market. She was instrumental in crafting a reinsurance program for insurers that lowered rate requests by 6 percent for 2018, preventing another year of double-digit rate increases to the individual market.

“I think Allen is great,” chimed in Rep. Rob Nosse of Portland, the Democratic vice-chair in the House Health Committee. “Not surprised he is bringing Laura either. She is great too.”

Allen said he would be splitting Fairbanks’ responsibilities, bringing in Kristine Kautz, a deputy director at the Department of Revenue, to work alongside Cali Robison as the chief operations officer.

Greenlick Defends Darby

Allen is also taking with him Dawn Jagger, who will act as communications chief as BethAnne Darby steps aside amid a scandal that embroiled the external relations department. Jagger has acted as a liaison to the public and federal government on health insurance issues, helping DCBS to craft an insurance program for Pacific islanders who are blocked from receiving Medicaid.

Although pressure had mounted on Saxton for months over eligibility and enrollment issues, the straw that broke the camel’s back was a scandal involving Darby and the external communications division, which made plans to badmouth the Medicaid provider FamilyCare Health and encourage the independent media to write negative stories about the coordinated care organization. The agency’s goal was to force an optimal settlement from the CCO, which has sued the agency repeatedly over reimbursements it considers unfairly and arbitrarily too low.

A whistleblower at the agency tipped the Portland Tribune to the communications team’s shenanigans, resulting in the handing over of damning documents that critics like Rep. Julie Parrish, R-West Linn, labeled a “House of Cards,” alluding to the machiavellian TV show.

But Greenlick defended Darby, saying she was the only one at the agency from whom he felt he could get a straight answer. “I don’t blame BethAnne Darby for that, it was all on Lynne,” he said. “The whole culture made FamilyCare the enemy.”

He also said FamilyCare and its chief executive, Jeff Heatherington, did not do themselves any favors by suing the state three times in court and embracing an adversarial role. “They’re making themselves the enemy and that’s not the way to do business.”

Heatherington told The Lund Report he would drop his lawsuit when the state gives them fair rates -- and he said preliminary numbers indicated the CCO would still operate at a loss for 2018.

From the office of Gov. Kate Brown, healthcare policy advisor Jeremy Vandehey will also be coming over to OHA to take over as the acting director of health policy and analytics -- a role currently held by Leslie Clement. Clement will fill in as director of the state Health Systems Division, which includes both mental health and Medicaid. In that role, she will replace Dr. Varsha Chauhan, who had already announced she was jumping ship earlier this month.

The email did not include a posting for a new chief medical officer, a position that has been vacant since July since the exit of Dr. Jim Rickards for Moda Health. The state Medicaid Director, Lori Coyner, also resigned ahead of Saxton and was replaced on an interim basis by David Simnit, who had been the health policy director.

Allen and Cali’s Departure Prompts DCBS Changes

Back at DCBS, deputy director Jean Straight will serve as acting director while J.P. Jones and T.K. Keen will cover for Cali Robison until a permanent insurance commissioner can be announced. The individual and small group rates for 2018 were recently finalized, giving the Division of Financial Regulations time until the next round of work must occur for the 2019 rates.

“They will split key stakeholder and issue responsibilities between them. Both have worked collaboratively with Commissioner Cali Robison over the years and are well versed in [Division of Financial Regulation] issues,” said Department of Consumer & Business Services spokesman Jake Sunderland.

“DCBS is a very large organization, and we have a very deep bench of talent here. The important work we do is bigger than any one person. The hard work on behalf of consumers at DCBS is the result of the collaboration of the many members of our healthcare policy team.”

Chris can be reached at chris@thelundreport.org

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