The Medicaid Program Could Have Achieved Savings If Oregon Had Applied Medical Loss Ratio Standards Similar To Those Established by the Affordable Care Act

In April 2016, the federal Department of Health and Human Services, Office of Inspector General (OIG) released this report regarding how the Oregon Medicaid program set medical loss ratios (MLRs) for its Medicaid managed care plans. The OIG sought to determine potential Medicaid program savings if the Oregon Health Authority, Division of Medical Assistance Programs, had required its Medicaid coordinated-care organization (CCO) plans to meet MLR standards for its traditional Medicaid population similar to the 85% standard for the expansion population established by the Patient Protection and Affordable Care Act (PPACA . . .