A federal audit of Oregon’s Medicaid program found $10 million in waste in 2014.
The state’s program, known as Oregon Health Plan, wasted $10.1 million with excessive overhead, according to the U.S. Department of Health and Human Services’ audit. The state could have saved that amount by requiring organizations providing healthcare to low-income people to meet the same standards as insurance companies.
The investigation arrived at the eight-figure sum by examining the potential savings for Oregon’s program if the state had required Medicaid coordinated-care organization plans to meet medical loss ratio standards for non-expansion individuals similar to those established by the Patient Protection and Affordable Care Act.
The audit examined 11 of Oregon’s 16 CCO plans for its expansion population. Three of those plans had MLRs below 85 percent, which is the ACA standard for large group insurers and Medicare Advantage Plus. Roughly $6.4 million of the total waste was federal money.
Nicholas joined TriMed in 2016 as the managing editor of the Chicago office. After receiving his master’s from Roosevelt University, he worked in various writing/editing roles for magazines ranging in topic from billiards to metallurgy. Currently on Chicago’s north side, Nicholas keeps busy by running, reading and talking to his two cats.