OHA will soon make a decision on Trillium’s application to serve OHP members in Tri-County region

The Oregon Health Authority (OHA) announced on Wednesday it will soon make a decision regarding Trillium Community Health Plan’s application to serve Oregon Health Plan members in the Tri-County area. The announcement is the latest development in Trillium’s long-running effort to move into the $1.5 billion-a-year Medicaid market in Multnomah, Clackamas, and Washington Counties.

 

 

In July 2019, OHA notified Trillium of its intent to award the coordinated care organization (CCO) a contract to expand services to Oregon Health Plan members in the Tri-County area beginning January 2020. Trillium currently operates in Lane, Douglas, and Linn Counties.

As outlined in this letter from OHA, the contract award was conditional due to application deficiencies. OHA laid out a series of actions – such as contracting with a hospital – that were needed in order to finalize the award.

After Trillium failed to contract with a Portland-areas hospital, OHA put the Medicaid contract on hold in November. OHA notified Trillium they had until June 30, 2020, to contract with a hospital and meet other network requirements or else they would lose their ability to serve OHP members in the Tri-County area.

Trillium submitted its updated provide network information in June, and OHA says it is currently in the process of reviewing the updated application materials. OHA says it will make a decision regarding the application by mid-August.

If approved, Trillium could begin enrolling members September 2020.