Oregon Gov. Kate Brown announced this week that she has decided to seek repayment of $64 million that was misspent by the Oregon Health Authority on patients that were not eligible to receive Oregon Health Plan benefits.

The decision will have an impact on the Umpqua Health Alliance, Douglas County’s only Coordinated Care Organization that caters to about 26,000 Oregon Health Plan members in the county, said Umpqua Health’s Director of Marketing and Communications Mark Tsuchiya.

Tsuchiya issued a statement saying Umpqua Health, which owns Umpqua Health Alliance, the coordinated care organization in Douglas County, is aware of the governor’s decision to seek repayment of the money that was erroneously sent to the CCOs in 2014 and 2015.

“Medicaid eligibility is determined by the state, and CCOs like Umpqua Health Alliance are required by law to provide specific services and health benefits to the members that the state enrolls,” Tsuchiya said in the statement.

It did not say how much the liability UHA might have, but the statement applauded the new OHA director for his efforts in getting the system straightened out.

“We commend the new OHA director for making a meaningful effort to identify issues that may exist in the state’s enrollment process,” Tsuchiya said in the statement.

Secretary of State Dennis Richardson said the errors were discovered by an investigation published in The Oregonian/Oregon Live, showing that the OHA made the improper payments between 2014 and 2016.

The governor sent her letter to the acting director of the OHA, Patrick Allen, asking him to seek repayment of the Medicaid funds that were wrongly paid out. In her directive on Tuesday, Brown asked Allen to come up with a progress report every two weeks.

State Rep. Knute Buehler, from Bend, who is running for the Republican nomination for governor, sent a letter Monday asking the governor to demand that the overpayments be paid back and for the release of all public records related to the Medicaid funds being misspent.

Beuhler said he intends to introduce legislation for the 2018 legislative session to legally require the repayment from providers of all inappropriately paid funds and to appoint an independent investigation to determine what went wrong and who was responsible.

“We need to get any misallocated money back, we need the public records released, and we need an independent investigation so we can make sure this never happens again,” Buehler said in a press release this week.

Reporter Dan Bain can be reached at 541-957-4221 or e-mail at dbain@nrtoday.com.

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Dan Bain is the health reporter for The News-Review. He previously worked at KPIC and 541 Radio.

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(1) comment


I understand they want to "get the money back" but back from whom? Who will end up paying money back to the state? Are they going to send a bill to individual people? Who was responsible for these improper payments to begin with?

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