Senate Passes Bill to Help CCOs Deal with OHA

The Legislature is considering a number of bills to improve the operations of the Oregon Health Authority. SB 833 gives CCOs time to review contracts. HB 2950 allows CCOs to assist their members with re-enrollment. SB 7 requires better oversight of new IT projects at the agency.

The Senate passed a bill Thursday that serves as exhibit A into how badly things were going last year at the Oregon Health Authority, requiring the agency to give the coordinated care organizations at least a month to review contracts before the deadline to sign them.

Sen. Alan Bates, D-Medford, called Senate Bill 833 the “Christmas Eve bill,” because the health authority waited until Christmas Eve to send the CCOs a contract that provided them with their funding stream for this year.  

The CCOs then had a week to sign the error-riddled contracts over the holidays, even as their state counterparts were unavailable, having taken off on vacation, “putting literally a million Oregonians at risk,” of losing their health insurance, said Bates.

SB 833 is among several bills designed to clean up the health authority’s act and taken together, cast a stark window into the opaque, dysfunctional and rudderless navigation that dominated the agency before new director Lynne Saxton was called in to right the ship.

Over in the House, CareOregon has introduced House Bill 2950, which, at its conception, aimed to address a laundry list of complaints with the state agency and improve the member experience for people with the Oregon Health Plan.

As upwards of a million Oregonians were trying to renew their Oregon Health Plan benefits last year, the health authority call center put people on hold for hours, even as the CCOs themselves were not allowed to re-determine the eligibility of their own members.

CareOregon Public Policy Director Martin Taylor testified last month in the House Health Committee that the health authority wouldn’t allow CCOs to re-enroll their own members directly, and the agency had said the federal government prohibited such action because it would interfere with competition between competing CCOs.

“That is not an accurate answer,” Taylor said. “The state of New York has a policy for plans to help with enrollment,” while ensuring people have a choice between competing managed care organizations. In much of the state, CCOs operate as monopolies regardless, making the safeguard moot.

Other items in the bill tackle waste, including sending multiple identical notices to households with more than one person on Medicaid and requiring the 16 CCOs to duplicate efforts for a member handbook.

CareOregon lobbyist Rose Englert said that if HB 2950 was borne out of frustration with the health authority, Saxton has been much more responsive to her organization’s concerns.

The call center in particularly has drastically reduced hold times, and many of the issues are now being addressed administratively, eliminating the need for new legislation, and others are on hold until the authority can get new technology from Kentucky up-and-running later this year to replace fatally flawed infrastructure developed by Oracle.

If CareOregon wants the House Health Committee to pass HB 2950, it will be as a heavily amended version that just gives CCOs the ability to assist their members with enrollment.

“It just makes sense that you could call your health plan to re-enroll,” Englert said.

SB 833 was pushed at the public hearing by two CCOs, FamilyCare in Portland and Willamette Valley Community Health in Salem.

“We need time to look over lengthy contracts,” said Bill Guest, director of Willamette Valley. “We want to ensure that our enrollees have good networks.”

Bates said the rates were wrong, and the contracts were ultimately rejected by the Centers for Medicare & Medicaid.

SB 833 will require the state to give CCOs 30 days to review new contracts or amendments. “It makes the Oregon Health Authority be much more responsible in its contracts with the CCOs,” Bates said.

The Senate also passed Senate Bill 7 sponsored by Senate President Peter Courtney, D-Salem, requiring the health authority to go through a process set up by the Department of Administrative Services for procurement of information technology services.

“It’s a technical fix, but it’s an extraordinarily powerful technical fix,” Courtney said.

SB 7 is an obvious repercussion from the health authority’s lead role in the Cover Oregon debacle and its infamous decisions tasking Oracle with building the failed health insurance exchange, giving Oracle a contract that wasn’t based on performance, and doing so without a systems integrator to oversee Oracle’s shoddy work.

Sen. Brian Boquist, R-McMinnville, told The Lund Report that the Department of Administrative Services has computer experts who could help make wiser choices about future information technology projects.

“As each agency screws something up, you have to go into DAS,” Boquist said, noting that the central agency started taking on its common-sense role as the central administrator for state IT projects after a $200 million failed system from the Department of Motor Vehicles. One by one, state agencies that have attempted to do projects on their own have failed, and the Oregon Health Authority is just the latest example, he said.

Editor's Note: While a member of Willamette Valley Community Health is a member of the Coalition of a Healthy Oregon, the CCO itself is not affiliated with the health alliance, as the original article indicated. We regret the error.

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