Senate Passes Bill to Prevent Medicaid Disputes
Impetus comes from a conflict last summer between CareOregon and FamilyCare
May 3, 2011 -- The Senate today unanimously passed a bill that attempts to avoid a similar dispute between Medicaid managed care organizations that occurred last year when a Portland-area pediatric group terminated its contract with CareOregon.
In the dust-up last summer, nearly 10,000 families ended up switching coverage for their children from CareOregon to FamilyCare so they could keep their doctors affiliated with the Children’s Health Alliance, a 110-member pediatric group.
The group had recently ended its contract with CareOregon and signed a new deal with FamilyCare. Rather than transfer those families directly, state officials offered them a choice, which had the potential to sow confusion and disrupt care. The fracas left a sour taste in many of those involved, including Sen. Alan Bates (D-Ashland) the chief sponsor of SB 201.
The bill allows the Oregon Health Authority to transfer 500 or more enrollees from one Medicaid plan to another in the event that they will lose access to their current doctors.
“We had no reasonable and easy way of transferring those patients,” Bates told his colleagues on the Senate floor Monday. “They were essentially told you don’t belong to the doctor taking care of you. You belong to the insurance plan.”
Bates said the bill is intended to send a strong message to the “organization responsible for this that this is not a practice we want to see continuing.”
The bill heads next to the House.
May 3 2011