Oregon Health Plan Turf Battle Results in Federal Anti-Trust Lawsuit

Trillium Community Health alleges OHSU, Providence and Legacy are illegally keeping Trillium out of the tri-county Medicaid market.

(Christine Dong)

Trillium Community Health Plan filed a federal lawsuit on Oct. 24 against Oregon Health & Science University, Legacy Health and Providence Health & Services, alleging that the "big three," as the lawsuit calls them, colluded to "illegally" block Trillium from competing to serve Oregon Health Plan members in the tri-county area.

"The Big Three have collusively agreed to refuse to contract their hospital and physician networks with Trillium," says the lawsuit, which was filed in U.S. District Court in Portland and first reported by The Portland Business Journal.

OHSU, Legacy and Providence are partners in Health Share, a coordinated care organization that serves all of the Oregon Health Plan's Medicaid patients in Multnomah, Washington and Clackamas counties.

Earlier this year, the state began a process of renewing the CCO program, which provides healthcare to low-income Oregonians. Currently, the tri-county is served by just one CCO, Health Share. Trillium, which operates in Lane County, and is owned by Centene, a publicly-traded provider based in Missouri, decided it wanted to compete with Health Share.

But in its lawsuit, Trillium says the big three Portland providers, each of which operates hospitals and extensive systems of clinics, would not play ball.

"Since  at  least  February  2019,  the  Big  Three  have  collusively  agreed  to refuse  to   contract  their  hospital  and  physician  networks  with  Trillium," the lawsuit says. Proof  of  the  Big  Three's  illegal  agreement  to  exclude  Trillium  includes  their   similar  responses  to  Trillium,  along  with  their  statements  against  individual  interest  conceding   their  collective  focus  on  supporting  Health  Share."

The defendants in the lawsuit don't think much of it.

"We are reviewing the litigation," says Providence spokesman Gary Walker. "We believe it is baseless, and the claims made in the lawsuit are not accurate. We look forward to resolving this through the legal process."

"While it is Legacy Health's practice not to comment on pending legal matters or litigation, we strongly disagree with the assertions made by the Centene Corporation," says Brian Terrett, a Legacy spokesman. "We look forward to letting the legal process occur in the appropriate venue."

"Although OHSU cannot comment on specific allegations, we have, and continue to negotiate in good faith with all who endeavor to contract/affiliate with us and remain dedicated to serving the Medicaid population of Oregon," adds OHSU spokeswoman Tamara Hargens-Bradley.

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