A former executive is suing Samaritan Health, alleging retaliation and wrongful termination after determining and informing the health care provider it was violating its contract to serve low-income Oregonians through the Oregon Health Plan.
In a lawsuit filed March 11, former Samaritan Health executive Melissa Isavoran claims she was retaliated against after informing Samaritan Health that it had processed inaccurate claims, prioritized members inadequately and discriminated unlawfully among health care providers — i.e., it paid more to Samaritan Health Services-affiliated providers than to other providers, according to the complaint.
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She claims that she shared her concerns to executive leadership throughout her 20-plus months of employment, but instead of addressing them in earnest, she was reassigned and edged out.
Samaritan Health declined to comment on the ongoing litigation.
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Samaritan Health Services operates five hospitals in Oregon, including locations in Albany, Corvallis and Lebanon. Under the same management, Samaritan Health Services provides coverage to individuals, employers, and under Medicare Advantage health plans, according to its website.
Both Samaritan Health Plans and Health Services are listed as defendants in the complaint.
Isavoran was hired in 2021 as the “assistant vice-president InterCommunity Health Plans,” making her responsible for Samaritan Health’s contract with Medicaid. As part of her duties, she was tasked with developing Medicaid programs and monitoring compliance with the Medicaid contract, according to the complaint.
Soon after being hired, she conducted a “gap analysis,” identifying areas of noncompliance with the Medicaid contract. While “marginal progress" was made, Samaritan Health did not address fundamental areas of noncompliance she had highlighted, according to the complaint.
Violations included inaccurate claims processing practices and administrative conflicts of interest, among other transgressions.
The lawsuit also claims that the health provider failed to check patients’ comorbidities, which resulted in the denial of benefits for those who otherwise may have qualified had their other conditions been reported.
In spring of 2023, Isavoran was removed from her position and placed in a new position overseeing the social determinants of health and was “completely cut off from Medicaid duties.”
“It was apparent to Plaintiff that the change resulted from her expressions of concerns regarding Medicaid noncompliance and Defendants concomitant desire to remove her from the Medicaid compliance arena,” the complaint reads.
The complaint alleges Samaritan Health intentionally failed to adequately support her in her new position by excluding her from information, meetings and engaging with community partners.
According to the suit, Isavoran’s whistleblowing led to her change in duties and subsequent “constructive discharge.”
After making a final attempt to speak with president and CEO Doug Boysen regarding her concerns, she was “asked to leave only a few hours later,” according to the complaint.
“We are not able to comment on this pending litigation at this time,” said Altove Rowley Esch, senior assistant general counsel at Samaritan Health Services.
The lawsuit seeks $460,000 in damages as well as back pay, lost benefits and other damages.
Shayla Escudero graduated University of Southern California with a Master of Science in Journalism. She covers Albany city hall and Linn County. She is passionate about telling people forward stories and shining a light on injustices. She can be reached at Shayla.Escudero@lee.net