Denied, Delayed, Then Dismissed: How EOCCO Handled Amanda’s Care — and Why It Matters for Eastern Oregon

By Levi Bakke

Published August 12, 2025

For more than a year, Amanda’s blood sugar stayed in the danger zone while her prescribed treatment, Mounjaro, was denied again and again. Critical safety equipment was approved, then suddenly revoked. Key medical evidence was altered or withheld. By the time coverage finally came through, the damage was done: new vision loss, worsening nerve damage, and permanent complications from uncontrolled diabetes.

Amanda’s case played out under the Eastern Oregon Coordinated Care Organization (EOCCO) — part of the Oregon Health Plan — a system owned by the very hospitals and providers it pays, controlling both the care and the purse strings.

What began as a routine prescription request became 14 months of denials and shifting justifications. EOCCO’s letters cited the wrong Oregon Administrative Rules, then the right ones — but still denied coverage. They alternated between calling the requirement “step therapy” and insisting it wasn’t.

All the while, EOCCO ignored clear clinical facts. Internal notes show they knew Amanda had an allergy to an entire drug class yet still demanded she take medications from that very class — contradicting her clinicians’ warnings. During this period, her A1C spiked from 8.1% to 11.6% and stayed dangerously high. Diet, vitamins, and supplements had no effect. The sustained hyperglycemia caused permanent harm: new diabetic retinopathy and worsened neuropathy.

In a separate incident, EOCCO approved Amanda’s continuous glucose monitor (CGM). Twice, her husband was woken by Dexcom alerts warning of a dangerous drop in her blood sugar. Days after Amanda began using this safety device — and after filing a formal complaint about her care — EOCCO revoked coverage. Internal records show they altered their own timeline, claiming they received the CGM request months later than they actually had, masking the retaliatory nature of the decision.

After months of appeals, Oregon set a contested case hearing. But just after Amanda’s hearing request reached the Oregon Health Authority (OHA), EOCCO abruptly reversed its denial, effective that same day. Under OHA rules, the reversal made the case “moot,” preventing the judge from hearing evidence or ruling on EOCCO’s process. On paper, the problem was solved. In practice, accountability was avoided.

Then came a curious follow-up: EOCCO approved a clinic visit for “back pain,” a condition Amanda had never reported and that appears nowhere in her records. It looked less like medical care and more like a token gesture — “have a back rub on us” — in a case where life-altering treatment had been withheld for more than a year.

Who Owns EOCCO — and Why It Matters

EOCCO is not an independent insurer. It is owned by the same providers it pays: Grande Ronde Hospital (Union County’s largest healthcare provider), Good Shepherd Health Care System (Hermiston), Saint Alphonsus Health System, Saint Anthony Hospital (Pendleton), Greater Oregon Behavioral Health, Inc. (GOBHI), Moda Health, Eastern Oregon IPA, and Yakima Valley Farm Workers Clinic.

These owners set policy, approve or deny care, and benefit financially whether services are delivered or denied. When the organizations providing care also control the coverage gate, conflicts of interest are inevitable.

A Unique Medical Profile — and Why the Delay Was Devastating

Amanda’s diabetes is unique. It wasn’t brought on by lifestyle, and she reacts badly to fast-acting insulin. The condition began after a pregnancy and worsened years later when a drop in estrogen rewrote her metabolism. Medications that once worked stopped working.

Today, her glucose can spike in the morning without eating or from something as simple as cleaning the house. Diet, vitamins, and supplements have done nothing to stabilize it — because this is not about habits, but a hormone-driven metabolic shift requiring precise, timely treatment.

This wasn’t just Amanda’s battle — it was mine. I am the one who wakes her when the Dexcom alarms, who lies awake when her sensors expire.

Amanda is my wife.

When I say I have lived what this community has experienced, this is part of what I mean. And as difficult, harmful, and exhausting as this was, it pales compared to what I’ve seen — and lived — trying to get help for others in this community.

I’ve stood with spouses like Patty, fought to protect Russell from overmedication and neglect, and documented systemic exploitation of our most vulnerable neighbors.

I’ve spent months filing reports, contacting legislators, and submitting evidence to oversight bodies from DHS supervisors to federal regulators — only to see the same patterns: delays, deflections, and denials, for profit.

What happened to Amanda isn’t an exception — it’s a pattern.

There’s a serious lack of advocacy in our valley. My goal is to arm you with knowledge so you can protect your family, and help your neighbor.

In our corner of Oregon, we value privacy and solving problems quietly. But this system thrives in that silence, keeping each family’s struggle isolated when neighbors may be facing the same thing.

Looking out for each other isn’t prying — it’s protecting. Sharing what’s happening is not gossip; it’s how we keep our community safe.

The next publication will show exactly why complaints and calls for help vanish into silence.