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SALEM, Ore. (AP) — Oregon Health Authority officials said Tuesday they have recovered about $42 million the agency overpaid to organizations that coordinate Medicaid benefits for as many as 1 million Oregon residents.

Officials repaid the money owed to the federal government, Health Authority spokesman Robb Cowie said, the Salem Statesman Journal reported Tuesday.

This comes after a Senate Republican from the city of Keizer revealed a proposal Monday for the state to demand the money back. State Sen. Kim Thatcher’s proposal would require the Health Authority to recover all overpayments to coordinated care organizations within 60 days of the bill’s passage.

Thatcher’s spokesman, Jonathan Lockwood, said Tuesday they want more answers from OHA regarding when and whether the bills were paid back before deciding whether to proceed with Thatcher’s legislative concept.

The issue dates back to late 2017, when an Oregon Secretary of State audit found the Health Authority could have avoided spending an estimated $76 million on patients who were members of coordinated care organizations but may have been ineligible for coverage under the Oregon Health Plan, also known as the state’s Medicaid program. The estimate included about $17 million in state money.

However, the overpayment figure ended up being about $42 million, Cowie said.

Thatcher’s proposal was designed to get coordinated care organizations to pay back the money.

“We need to know why this has been allowed to happen and how we can prevent it from ever happening again,” she said in a statement. “Every dollar thrown away is a dollar robbed from taxpayers that is not spent on promised health care for those most in need.”

The legislative move comes after the Oregon Health Authority opened the application period for coordinated care organizations that want to serve Oregon Health Plan patients from 2020 to 2024.

Patrick Allen, the Health Authority’s director, said last week the contracts “will shape the next five years of care that 1 million Oregonians rely on.”

The 1 million figure is disputed, however. State auditors in 2017 found that only about 800,000 patients are covered through coordinated care organizations. That’s because certain Medicaid users, including tribal members, don’t have to enroll in coordinated care organizations, according to the audit.


Information from Statesman Journal