Oregon Public Broadcasting

Oregon Supreme Court Ruling Prompts Families To Try To Recoup Medicaid Payments

When a couple grows old, one spouse often gets sick and needs long-term care — like a nursing home. That can cost $6,000 a month.

To qualify for Medicaid, couples often transfer the title for an asset, like a home, to the other spouse.

In 2008, the state tightened the rule governing asset ownership in an effort to recover more money. Now the Oregon Supreme Court has found that exceeded the state’s authority.

Attorney Tim Nay said they’re looking for families to come forward.

“We think it’s time for the state to give back the money they received illegally from Medicaid families in the past,” he said.

The rule brought in an estimated $10 million a year for Oregon.

By law, the state has to recover Medicaid expenses from an estate once both people are dead.

The Oregon Department of Health And Human Services declined to comment for this story.

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PeaceHealth Southwest Maintenance Workers Vote To Unionize

About 900 service and maintenance workers at PeaceHealth Medical Center in Vancouver, Washington, have voted to unionize.

The hospital employees will join the American Federation of Teachers, the union announced last week.

“The union is a vehicle for these workers to help their patients and themselves—to ensure the patients they serve receive the care they need, and to fight for the wages and fair treatment on the job that every worker at PeaceHealth deserves,” Randi Weingarten, AFT President said in a statement.

Hospital staff joining the union said they want to make the medical center a better place to work and improve care for patients.

Debra Miller, system vice president of labor and caregiver relations, said PeaceHealth is waiting for the National Labor Relations Board to certify the vote before starting contract negotiations.

“PeaceHealth has a long-standing, proven track record of respecting our caregiver’s rights to seek representation – this latest election is no different,” Miller said in a statement. “We are grateful to our caregivers for assuring their voices were heard in the recent election, and grateful to them for assuring patient care remains in the forefront of any future bargaining efforts.”

Earlier this year, tech workers at the medical facility also voted to join the AFT. Once made official, the union will represent 3,000 employees at PeaceHealth Southwest.

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Insurers To Get Reminder About Oregon's Prescription Birth Control Law

A new law this year in Oregon requires insurance companies to cover a 12-month supply of prescription birth control, but its backers say some insurers haven't gotten the message.

One of those backers is Mary Nolan, director of Planned Parenthood Advocates of Oregon, which helped lead the push for the 2015 legislation. 

Nolan said when she stopped to pick up a prescription for her daughter last month, "the pharmacist was not aware of the law, and the health insurance carrier denied the claim for extended coverage because their claims adjusters weren't aware of the law."

Nolan told her experience Monday to a meeting of the Oregon Senate's Health Care Committee. She said Planned Parenthood has heard similar stories from many Oregon women.

The state's Department of Consumer and Business Services confirmed it's heard so many complaints that it's issuing a bulletin to insurance companies reminding them of their obligations.

Failure to comply with the birth control law is a violation of the Oregon Insurance Code, which could subject the insurer to civil penalties.

Insurance companies testified to the panel that they are working to make sure their providers are up to speed on the legislation.

Jessica Adamson, a lobbyist for Providence Health, also said a "technology glitch" prevented the automatic approval of 12-month birth control prescriptions at pharmacies that are a part of the Providence network.

"But the pharmacist or member could make the phone call and it would be approved through the claims department," Adamson said.

It took Providence more than 11 months to fix the glitch after the law took effect in January.

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Governor Wants To Secure A Slimmed-Down Medicaid Waiver Before Trump Takes Office

Oregon Gov. Kate Brown is trying to squeeze a new, slimmed-down health care waiver out of the federal government — before the Trump administration starts.

Oregon has had a Medicaid waiver since 1994 when former Gov. John Kitzhaber started the Oregon Health Plan.

The latest extension was granted in 2012 and sunsets next year. It allowed the state to roll out a new system of Coordinated Care Organizations.

Before the 2016 presidential election, the state hoped the new extension would allow them to support the homeless and the hungry, saying that would improve the health of a whole population.

But now, because of President-elect Trump’s stated intention to repeal Obamacare, the governor’s advisor, Jeremy Vandehey, said they’re asking the Centers for Medicaid Services, for a quick renewal before the new administration is in office. “Given the amount of time that’s left," said Vandehey. "It would have to be a much more straightforward extension and it likely would not include a lot of the bigger asks, that we frankly weren’t expecting to have with CMS until next year anyway.”

2012’s waiver extension came with $1.9 billion of federal support. Hopes for similar support for the next extension have faded, meaning the Oregon Health Plan is facing significant cuts.

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Oregon Says Its Plan Could End HIV Infections By 2021

Oregonians have a 1 in 200 chance of being diagnosed with HIV, according to the CDC.

But the Oregon Health Authority thinks that by focusing on three key strategies, all new infections can be stopped by 2021.

Dr. Sean Schafer with the Public Health Division said the first strategy is get more testing for the infection done in the state.

“Testing’s easy. Everyone has an HIV status. You’re either positive or you’re negative and you should know it," Schafer said. "When people know their status, they immediately take steps to avoid infecting others. And they start medical treatment.”

Only 35 percent of Oregonians have been tested.

The two other strategies are prevention — that is, high risk individuals taking a pill to stop them passing-on the virus — and treatment. Thanks to modern drugs, individuals who get early treatment can lead long lives.

Health departments are applying for grants to help cover any extra cost.

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