Oregon health agency's money troubles double in new report

Article author: 
Hillary Borrud
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Article date: 
Monday, November 20, 2017
Article category: 
Oregon Issues
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Money problems at the Oregon agency that oversees Medicaid could be more than twice as large as already disclosed, a new report reveals.

Due to errors involving abortion, prison, undocumented immigrants and other factors, the state might have overpaid its contractors or owe other entities as much as $78 million...

....Allen listed $34 million that he said is owed to the agency or went untapped, due to budget and accounting problems....

The disclosures hint at the red meat the reports could serve up to the campaign to overturn $340 million in health taxes enacted to fund the state's Medicaid program....

In his letter to the governor on Friday, Allen laid out problems that ranged from the state paying Medicaid benefits for unauthorized immigrants to incorrectly using federal funds to pay for abortions.

Allen was careful to say that in most cases, staffers are still investigating the problems and the figures and other details will likely change as they learn more. He cited the following problems:

Medicaid for unauthorized immigrants: Oregon incorrectly paid health care organizations it contracted with to care for an undisclosed number of unauthorized immigrants, who were mistakenly listed in the state's computer system as being eligible for more than emergency room care. Allen did not identify the time frame in which the problem occurred, but it caused $25.7 million in "payment errors....

Health officials are still investigating another potential problem related to immigrants in the country illegally. Medicaid covers some emergency care for unauthorized immigrants plus prenatal and delivery care for pregnant women. As health staffers were preparing to implement a new abortion law earlier this year, they discovered the state might have been keeping these mothers on Medicaid after their babies were born, a time when the women were no longer eligible, Allen wrote....

Bariatric surgery payments: Oregon paid more than it should have for these weight loss surgeries from 2009 through 2015, and started trying to recoup the $1.5 million in overpayments a year ago. "As of October 2017, most of the overpayments have still not been repaid by providers, resulting in an accounts receivable balance of $1.1 million," Allen wrote....

Abortion coverage: The state estimates it used $1.8 million or so in federal funds for abortions, which it will have to repay. Federal law generally bans using federal funds to pay for abortions, although there are exceptions for cases of rape, incest and when the pregnant woman's life is in danger, according to the American Civil Liberties Union.

>>Money due to drug labelers: Oregon owes an estimated $22.3 million to drug labelers because the state has not passed along some of the money it was supposed to as part of the Medicaid drug rebate program.

Allen also cited problems at his agency and elsewhere with getting money to the right places. They included:

>> State accounting problem: The health authority has received an estimated $20 million from the Division of Child Support to pay for children's health care but has not properly accounted for that money. So state and federal programs were billed for the children's health care.

>>State budget problem: The health agency could gain $14.1 million for nursing facility and post-acute care that was incorrectly sent to the Department of Human Services over the past year.

The health authority might also be able to get federal money for services it has not sought reimbursement for in the past, or for which it claimed less federal funding than it could have, Allen wrote. Examples include services provided to tribal members at non-tribal facilities, and certain preventive services.

Rosario JumpingBull gets a new filling placed by dental assistant Dustie Munsey, right, and Dentist Dr. Jeff Thayer, not pictured. at Deer Ridge Correctional Institution in 2011. Brian Feulner/ The Oregonian(Brian Feulner)

Patrick Allen is director of the Oregon Health Authority.