Moda Health

Originally started as part of the Oregon Dental Society (now the Oregon Dental Association), the company began as a dental insurance plan. In 1995, the Oregon Department of Justice investigated claims of anti-trust issues related to a most favored nation clause in its contracts with dentists, which led to the removal of the clause.{{cite news|title=Choice in the dental chair|url=http://www.bizjournals.com/portland/stories/1997/03/10/editorial1.html|accessdate=2 April 2014|newspaper=Portland Business Journal|date=March 9, 1997}} The company announced in 1996 it would move to what became the ODS Tower.{{cite news|last=Goldfield|first=Robert|title=ODS Health to anchor Wright Runstad tower|url=http://www.bizjournals.com/portland/stories/1996/09/23/story2.html?page=all|accessdate=2 April 2014|newspaper=Portland Business Journal|date=September 22, 1996|author2=Kathy Brock}} In July 1999, ODS moved into the new office building, and the next month sold its former headquarters for $9.6 million to the retirement trusts for Les Schwab Tires and law firm Stoel Rives.{{cite news|title=Les Schwab and Stoel Rives Retirement trusts buy ODS Plaza|url=http://www.bizjournals.com/portland/stories/1999/08/09/daily4.html|accessdate=2 April 2014|newspaper=Portland Business Journal|date=August 10, 1999}} ODS changed its name to Moda Health in May 2013, though it kept the ODS moniker for its dental plans in Oregon.{{cite news|last=Stevens|first=Suzanne|title=ODS changes its name, shifts focus|url=http://www.bizjournals.com/portland/morning_call/2013/05/ods-changes-its-name-shifts-focus.html|accessdate=2 April 2014|newspaper=Portland Business Journal|date=May 6, 2013}} Later that year it announced a sponsorship deal with the NBA's Portland Trail Blazers, in which the former Rose Garden Arena would be renamed as the Moda Center. The company is also the shirt sponsor of National Women's Soccer League side Seattle Reign. As of 2013, the company had nearly 1,400 employees and $1.7 billion in annual revenues.{{cite news|last=Meyers|first=Sean|title=Health care changes put Moda into growth mode|url=http://www.bizjournals.com/portland/print-edition/2013/07/26/health-care-changes-put-moda-into.html?page=all|accessdate=2 April 2014|newspaper=Portland Business Journal|date=July 26, 2013}}

The risk corridors program under the PPACA section 1342,{{citation |url=http://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |title=Lawsuits to Recover Payments under the Risk Corridors Program of the Affordable Care Act |date=January 5, 2016 |accessdate=February 11, 2017|author= Legislative Attorneys, American Law Division |publisher=Congressional Research Service |pages=6}}{{rp|1}} was a temporary risk management device, modeled on similar successful risk corridors in

Medicare Part D,{{citation |url=https://www.forbes.com/sites/theapothecary/2015/12/15/yes-marco-rubio-led-the-effort-to-end-obamacares-health-insurance-slush-fund |work=Forbes |title=Yes Marco Rubio led the effort to end Obamacares health insurance slush fund |date=December 15, 2015 |accessdate=February 10, 2017}} to encourage reluctant insurers into the "new and untested" ACA insurance market during the first three years that ACA was implemented (2014-2016).{{citation |url=http://www.latimes.com/business/hiltzik/la-fi-hiltzik-risk-corridor-moda-20170210-story.html |title=With billions at stake, a federal judge just nullified the GOP's most cynical attack on Obamacare |newspaper=LA Times |date=February 10, 2017 |accessdate=February 10, 2017 |author=Michael Hiltzik}} While the program did succeed in attracting insurers, it did not pay for itself and suffered billions of dollars of losses and funds were to be paid from "general government revenues". Congressional Republicans "railed against" the program as a 'bailout' for insurers. and in 2014, then-Rep. Jack Kingston (R-Ga.), on the Appropriations Committee that funded the HHS "[slipped] in a sentence" — Section 227 — in the "massive" spending bill that said that no funds in the discretionary spending bill "could be used for risk-corridor payments." This effectively "blocked the administration from obtaining the necessary funds from other programs."{{citation |url=https://www.washingtonpost.com/news/fact-checker/wp/2015/12/23/rubios-inaccurate-claim-that-he-inserted-a-provision-restricting-obamacare-bailout-funds/ |title=Rubio's inaccurate claim that he 'inserted' a provision restricting Obamacare 'bailout' funds |author=Glenn Kessler |date=December 23, 2015 |accessdate=February 11, 2017}} Moda, and a number of other insurers, suffered financially.{{citation |title=Trouble on the Exchanges — Does the United States Owe Billions to Health Insurers? |author=Nicholas Bagley |journal=New England Journal of Medicine |date=November 24, 2016 |doi=10.1056/NEJMp1612486 |volume=375 |issue = 21|pages=2017–2019 |pmid=27959725}}

As a result, in January 2016, regulators in Oregon and Alaska temporarily suspended the ability of Moda Health to sell insurance after large financial losses left it with a lack of capital.{{cite news|last1=Hayes|first1=Elizabeth|title=State forces Moda Health to exit individual insurance market, requires it to raise capital|url=http://www.bizjournals.com/portland/blog/health-care-inc/2016/01/state-forces-moda-health-to-exit-individual.html|accessdate=February 15, 2016|work=Portland Business Journal|date=January 28, 2016}}{{cite news|last1=Manning|first1=Jeff|title=State forces tight controls on Moda, citing insurer's weakened financial condition|url=http://www.oregonlive.com/business/index.ssf/2016/01/state_takes_control_of_moda_ci.html|accessdate=February 15, 2016|work=The Oregonian|date=January 28, 2016}} The restrictions were lifted in February 2016 after the parent company agreed to raise additional funds.{{cite news|last1=Sickinger|first1=Ted|title=Moda can continue to operate under agreement with regulators to inject new cash|url=http://www.oregonlive.com/business/index.ssf/2016/02/regulators_reach_agreement_on.html

|accessdate=February 15, 2016 |work=The Oregonian|date=February 8, 2016}}{{cite news|last1=Bohrer|first1=Becky|title=Moda Health suspension lifted; company must raise $179M|url=http://www.alaskajournal.com/2016-02-10/moda-health-suspension-lifted-company-must-raise-179m|accessdate=February 15, 2016|work=Alaska Journal of Commerce|date=February 10, 2016}}

Moda Health took the case to court and won a "$214-million judgment against the federal government". On February 10, 2017, Judge Thomas C. Wheeler stated, "the Government "made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, 'to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."{{citation |url=https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |title=Moda Health Plan, Inc. v. The United States |publisher=US Courts|date=February 10, 2017 |accessdate=February 10, 2017 |pages=40}}

On June 14, 2018, the U.S. Court of Appeals for the Federal Circuit Court overturned the lower court ruling, reversing the $214 million judgment.{{citation |url=https://www.kgw.com/article/money/business/in-a-reversal-moda-loses-214m-appeal-against-the-federal-government/283-564446019 |title=In a reversal, Moda loses $214M appeal against the federal government |publisher=KGW|date=June 14, 2018 |accessdate=June 20, 2018}} The Supreme Court later ruled in favor of Moda Health.{{Cite web |last=Manning |first=Jeff |date=2020-04-28 |title=Moda wins long-shot $250 million lawsuit against federal government |url=https://www.oregonlive.com/business/2020/04/moda-wins-long-shot-250-million-lawsuit-against-federal-government.html |access-date=2023-06-09 |website=oregonlive |language=en}}

{{Reflist|30em}}

• [https://www.modahealth.com/ Official website]

Category:Companies based in Portland, Oregon

Category:Healthcare in Portland, Oregon

Category:Health insurance companies of the United States

Category:American companies established in 1955