The Oregon Health Authority has had its share of problems this year, not the least of which was an “audit alert” from Secretary of State Dennis Richardson’s office in May. The alert came as state auditors discovered OHA had fallen behind in checking eligibility for Oregon Health Plan (Medicaid) clients. The governor stepped in and gave OHA until the end of August to get the job done, and, on the last day of the month, it did so.
It was no easy task. The federal government requires that Medicaid eligibility be redetermined each year. In Oregon, with just shy of 1 million Oregon Health Plan recipients, that’s a task that requires either a fleet of people or a computer system that’s up to snuff. OHA had neither.
To make matters worse, beginning in 2013 the federal government allowed the state to skip annual continuing eligibility evaluations for several years. The last waiver expired in June 2016, and the state began doing the required checking, though slowly.
The problem came to a head in May with Richardson’s audit alert. At the time, nearly 12 months after the waiver expired, more than 80,000 Oregon Health Plan clients remained to be checked. The job was completed Aug. 31, right on time.
The state removed more than 54,000 people from the program. The costs add up.
Oregon pays some $430 per Oregon Health Plan client per month, and finding the money to do that has become problematic.
The health plan is expensive, and its cost will only grow in the years ahead as federal payments for Medicaid decline. Assuring that everyone who is on the Oregon Health Plan is entitled to be there is critical. And had it not been for Secretary of State Richardson and his audit alert, Oregonians might never have become aware of how far away from being able to make that assurance the OHA really was.