Trillium Community Health Plan was dealt a blow late last week after Oregon officials notified the insurer that it cannot expand into the Portland, Ore., market, according to The Oregonian.
The regulators' decision comes just a few weeks after the health plan filed a federal antitrust suit against three of the largest hospital systems in Portland, claiming they colluded to block the insurer from operating in the area. The suit was filed against Legacy Health, Providence and OHSU Health System, all based in Portland.
In July, the Oregon Health Authority named Trillium a "next generation" coordinated care organization and awarded it the contract to serve Medicaid patients in the Portland area. CCOs, as they are known, work together to provide healthcare services and benefits to patients enrolled in the state's Medicaid program.
The health plan said that it "pursued every avenue" to work with Legacy, Providence and OHSU, without success.
The plan noted that the three hospital systems are all founding members of Health Share, the existing CCO in the area that would have competed against Trillium.
The state decided that Trillium will not be able to expand into Portland this year. Instead, the 40,000 metro-area Medicaid members will move under Health Share.
The state said it will give Trillium another shot next year if it is able to build an adequate network of partners by June 30, 2020.
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