PORTLAND, Ore. (KATU) \u2014 Oregon\u2019s Medicaid program may have paid health care networks twice for some of the same patients, according to a new state audit. <\/p>\n
The audit, released by Secretary of State Tobias Read\u2019s office, found that the Oregon Health Authority (OHA) made duplicate monthly payments when the same Medicaid recipient had more than one account number in the state\u2019s system.<\/p>\n
OHA pays Coordinated Care Organizations, or CCOs, a flat monthly fee for each person enrolled, whether that person uses care that month or not.<\/p>\n
Auditors reviewed more than two million Medicaid IDs from 2020 through 2024. They identified 645 potentially duplicate pairs, tested 56 of them, and found $230,252 in overpayments.<\/p>\n
Auditors directly identified $230,252 in overpayments. Based on their sample, they estimate the statewide total may range from $232,000 to $4.1 million over the five years.<\/p>\n
The Oregon Department of Human Services (ODHS) estimated there were more than 11,000 duplicate IDs in the system as of March 2026. Auditors said that does not mean all of those IDs resulted in duplicate payments.<\/p>\n
The Oregon Health Plan provides Medicaid coverage to about 1.4 million people, or roughly one in three Oregonians.<\/p>\n
Oregon spent $19 billion on Medicaid in 2025, including $13 billion in federal funding.<\/p>\n
Federal rules require states to return the federal share of identified overpayments within a year.<\/p>\n
OHA Audit 9-16PDF previewPreview PDF<\/p>\n
View PDF<\/a><\/p>\n