oregon health authority

Behavioral Health Director to Leave Oregon Health Authority

Word of Royce Bowlin’s planned departure comes shortly after OHA Director Patrick Allen announced a reorganization of the agency.

The Oregon Health Authority’s behavioral health director, Royce Bowlin, is resigning effective July 3, prompting concern from advocates that high turnover in recent years is detracting from efforts to address addiction and mental health in the state.

By: 
Courtney Sherwood
The state had originally said it would not seek repayments from 2014 and 2015 for elderly adults who were misclassified as younger adults. But as political pressure mounted, OHA is now ordering its Medicaid contractors to square up their books.

The Oregon Health Authority is calling back $41 million in overpayments it made to the state’s Medicaid contractors in 2014 and 2015 due to classification errors.

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The judge ordered the Oregon Health Authority to release documents related to coordinated care organization rate setting, though the legal dispute is far from over.

FamilyCare inched one step forward last Friday in its years-long series of legal disputes with the Oregon Heal

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Although FamilyCare stopped operating as a coordinated care organization on Jan. 31, it is still suing the Oregon Health Authority in state court over rate-setting for Medicaid. Now the Oregon Health Authority’s director has filed a federal lawsuit challenging the nonprofit.

The Oregon Health Authority has sued FamilyCare in federal court, out of apparent concern that the former coordinated care organization’s continuing dispute with the state could jeopardize 2018 Medicaid agreements with Oregon’s 15 surviving CCOs.

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At two town-hall meetings this weekend, officials will meet with medical providers to answer questions about the closure of the state’s second-largest coordinated care organization at the end of January.

As the state's second-largest coordinated care organization exits the Medicaid market and transfers its roughly 115,000 members to other CCOs, it’s inevitable that some patients and providers will experience a bumpy transition, Oregon Health Authority Director Patrick Allen said on Thursday.

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The Oregon Health Authority says each CCO is free to set its own provider payment rates. But a $26.2 million cut to FamilyCare’s base reimbursements would have forced the Medicaid provider to make cuts it was not willing to consider. Instead, it will shut down at the end of January.

Months before FamilyCare announced its plans to shut down rather than accept the Oregon Health Authority’s reimbursement rates, the Portland-based coordinated care organization’s leaders argued that they were being treated unfairly by the state, thanks to payments that were much lower than the ot

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A Letter to The Oregon Health Authority

By: 
Susan Wolfer

At the stroke of midnight, December 31, 2017, about 120,000 Oregonians will have to find all new healthcare providers within HealthShare if the inequity in funding FamilyCare is not addressed. 

It Doesn’t Make Sense

As FamilyCare Prepares to Close, CEO Hears Plea to Take More Time

After a testy meeting between FamilyCare’s leader, the Oregon Health Authority and Governor Kate Brown, state officials say they are planning for transition. Meanwhile, providers and patients are confused about their fate. And now Jeff Heatherington says he may keep his nonprofit operating for 90 more days – if his board agrees.

FamilyCare President and CEO Jeff Heatherington promised Wednesday night to discuss with his board the possibility of staying open for three more months rather than shutting down at the end of this year as he earlier had said he would do, after dozens of angry and concerned physicians and mental

By: 
Courtney Sherwood

New Cover Oregon Error May Put State on Hook for $74 Million in Overpayments

An examination of records by the new leadership at the Oregon Health Authority discovered that an error in the Cover Oregon process caused the state to categorize older, Medicare-eligible adults in the Medicaid expansion.

The Cover Oregon debacle continues to dog the Oregon Health Authority. Actuaries have newly discovered that more than 41,000 people were miscategorized over three years, which caused the state to draw down $74 million more federal dollars than it was allowed.

By: 
Chris Gray

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