A lawsuit has been filed against the state by one of the Oregon’s largest Coordinated Care Organizations for having an “unsound rate-setting process.”
About 120,000 Portland residents are being served by the FamilyCare Health on the Oregon Health Plan.
any CCO — in one case 17% less than its neighbor.
Jack Coleman, FamilyCare spokesman, said that they were compelled to file suit after the state denied to give data to show how the rates were calculated.
Coleman said, “In few cases, we’re told that the data is proprietary. In another case, we get no information at all.”
We want “transparency and fairness” in the rate setting procedure, Coleman said.
This isn’t the first time FamilyCare has filed a lawsuit against the state on this reimbursement rates issue.
No comment has been given by the Oregon Health Authority on the on-going lawsuits, but spokesman Robb Cowie stated that its rates are totally fair and are approved by the federal government.