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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.
