Trillium May Resume Enrolling Oregon Health Plan Members in Portland Metro Area, State Says
The insurer has made enough progress for its freeze to be lifted, but more improvements are still needed, Oregon Health Authority said.
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The insurer has made enough progress for its freeze to be lifted, but more improvements are still needed, Oregon Health Authority said.
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The state says its clampdown on the CCO stems from Trillium’s inadequate efforts to improve services to members in Multnomah, Clackamas and Washington counties.
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Trillium appears substantially short of meeting standards set by the Oregon Health Authority for the Oregon Health Plan, documents show.
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Providers continue to question the Oregon Health Authority’s decision to let the for-profit company serve Medicaid members in the tri-county Portland area.
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The agency outlines changes that the coordinated care organization has to make to enter the Portland-area Medicaid market.
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Trillium can start to enroll Oregon Health Plan members in those regions on Sept. 1 but will have to beef up its behavioral health care provider network and meet equity requirements.
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The for-profit Medicaid insurer has contracted with Oregon Health & Science University and Legacy for some services but failed to woo Providence Health & Services.
Trillium Community Health Plan has abandoned its lawsuit against three large providers in the Portland area.
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A new five-year round in Oregon’s Medicaid system has just begun and already it’s taken a toll on Trillium Community Health Plan, a for-profit insurer facing competition for the first time on its home turf.
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Trillium Community Health Plan has stepped back from its push for an injunction against three Portland-area hospital systems.