Compared to other states, Oregon has lagged behind in coverage for patients with venous issues in its Medicaid program. Over the last several years, our team at Inovia Vein has advocated strongly that there should be improved coverage for vein patients with Medicaid through the Oregon Health Plan.
What Does Medicaid and the Oregon Health Plan Currently Cover?
Currently, most insurance companies and Medicare provide coverage for patients with symptomatic varicose veins that are impacting their daily activities and quality of life. But the Oregon Health Plan, which provides Medicaid health insurance to those in Oregon, has only covered the most advanced stages of venous insufficiency (those with end stage venous ulcers). This means many OHP patients must wait until the end stages of vein disease to qualify for treatment.
What is Changing in OHP Coverage for Vein Conditions?
After several attempts made by our staff to present public comments directly to the Oregon Health Evidence Review Commission (HERC) on this subject, we are pleased to announce that the HERC advised adding at least one more indication for vein treatment: recurrent episodes of cellulitis due to chronic venous insufficiency.
This will help many patients who end up with ankle discoloration and severe stasis dermatitis after years of recurrent cellulitis due to venous insufficiency. This is a process that takes years to develop; it may start with varicose veins and swelling, but over time the skin by the ankle becomes red and inflamed, then transitions to a brown coloration with the skin turning from soft to hard, typically just above the ankle. This is called Lipodermatosclerosis, or LDS.
Since LDS is usually permanent, its ideal to treat these symptoms as early as possible. These updates to the Oregon Health Plan coverage will help prevent LDS from developing.
Our Mission for More Equitable Vein Coverage in Oregon is Not Over
The addition of recurrent episodes of cellulitis due to chronic venous insufficiency is an improvement in Medicaid coverage for patients in Oregon, but there are several other symptoms that can benefit from early treatment.
In the past, Inovia Vein has advocated for extending Medicaid coverage in Oregon to refractory dependent edema and pain that impacts activities of daily living, two common symptoms of varicose veins.
There is a large body of literature and ample high-quality peer reviewed evidence that supports the earlier treatment of symptomatic varicose veins, before they become end stage and result in permanent damage to the skin. This is the reason nearly all insurance payers (Public and Private) cover varicose vein treatment in this fashion.
So while the Oregon Health Plan continues to cover a more limited scope of venous insufficiency issues, we will take the opportunity to continue to advocate for expanded coverage for varicose vein treatments whenever public comment is sought by the state.
Are You on the Oregon Health Plan and Looking for a Vein Doctor?
If you are interested in learning more about varicose veins treatment options, simply fill out our Online Appointment Request Form or call any of our clinics in Northwest Portland , Tigard, Happy Valley or Bend, Oregon.