CMS

State Over Billed The Feds for Family Planning

The Lund Report
The state refunds the federal government $1.7 million with another $3 million under review

February 22, 2011 -- A federal audit recently found the Oregon Health Authority improperly claimed $1.7 million in federal reimbursement for a program that offers family planning services to low-income Oregonians

A routine audit by the Office of Inspector General for the Department of Health and Human Services found the state had not properly verified the income or social security numbers of enrollees to an expanded Medicaid program known as Oregon Contraceptive Care also called the Family Planning Expansion Project

Fast Track Legislation Scrapped, Lacking Political Support

The Lund Report
It’s rumored that CMS would not have given Oregon additional money to fund coordinated care organizations had the fast track option succeeded

February 9, 2012— The managed care plans that are currently providing services to Oregon Health Plan members appear to have lost their bid to create what’s known as “fast track,” legislation, giving them the ability to turn into coordinated care organizations (CCOs) by July, without having to meet all the criteria, guidelines and the certification process developed by the Oregon Health Policy Board.

CMS Fines Regence $100,000 for Medicare Violation

The Lund Report
The board members of The Regence Group listed below represent the company’s four states – Oregon, Washington, Idaho and Utah

November 30, 2011 – The Centers for Medicare and Medicaid Services has imposed a $100,000 civil penalty against The Regence Group for failing to provide accurate information to its Medicare Advantage members. The Regence Group is the holding company for the company’s insurance products in Oregon, Washington, Idaho and Utah.

Oregon Looking for Federal Dollars to Fund Transformation Process

The Lund Report
The Oregon Health Authority wants to use federal savings to help fund the start up of CCOs

November 10, 2011—Dr. Bruce Goldberg is in active discussions with the Centers for Medicare and Medicaid Services (CMS) to see if federal funds are available to jump start the coordinated care organizations (CCOs) which will provide physical, mental health and dental services to more than 630,000 people on the Oregon Health Plan next July.

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