The American Association for the Study of Liver Diseases recommends that Sovaldi be used with patients with late-stage liver disease, but state bureaucrats were ready to block coverage for all patients because of the high price tag of the drug and a report from OHSU’s Center for Evidence-Based Policy that raised red flags about the drug’s studies, helping the state in its attempt to get out of paying for treatment.
Public-owned hospitals such as Bay Area, Blue Mountain, Coquille Valley, Curry General, Harney District, Lake District, Lower Umpqua, Pioneer Memorial, Southern Coos and Wallowa Memorial struggle to remain independent.
Among the private insurers, Regence BlueCross BlueShield is the lowest payer and reduced its rates over the past two year, while a new contract is under negotiation.
Gov. John Kitzhaber proudly wrote of PEBB’s success in controlling costs while offering new options that transform the way healthcare is delivered, aligning the health plan for public employees closer to Oregon’s managed care revolution for Medicaid.
PacificSource asks the Insurance Division to lower its proposed rate hike from 15.9 percent to 10.8 percent. Providence and Kaiser successfully lobbied the division last year to lower their requested premium rates after they had been priced above the competition.
The federal government requires Oregon to have a strategic behavioral health plan for how it will use block grants. The plan will also help the state comply with the U.S. Department of Justice while integrating the work of the CCOs to lay out how the state will get services to those who need them.
The transition team at Cover Oregon expects to choose a systems integrator on Friday who can link the federal enrollment website for private insurance plans and, separately, finish building a state system to manage Medicaid enrollments.
