CareOregon and Columbia Pacific CCO tighten outpatient behavioral‑health billing to contracted providers; county commissioners raise licensure and rural access,

Rachel [last name not provided], a representative of CareOregon and Columbia Pacific CCO, told the Clatsop County Board of Commissioners that CareOregon has enacted two behavioral‑health policy changes intended to narrow Medicaid reimbursement to credentialed, contracted providers and to improve oversight of care for members with the greatest needs.

The first policy, CareOregon said, went into effect Aug. 1 and removes reimbursement eligibility for certain provider types billing Medicaid as individual, uncontracted providers when providing routine outpatient mental‑health and substance‑use services. The CCO also announced a second policy requiring routine outpatient mental‑health and substance‑use disorder services be provided only by contracted outpatient providers; that change is scheduled to take effect Oct. 1. Rachel said the two policies are separate from Oregon Health Authority (OHA) rulemaking but that CareOregon will align with any future OHA rule changes if they occur.

Why this matters: CareOregon framed the changes as a way to focus limited resources on organizations that can provide a full spectrum of services, maintain credentialing and clinical oversight and coordinate crisis and primary‑care connections for Medicaid members with complex needs. "Our behavioral health strategy is rooted in ensuring our members, especially those living with the most complexity, receive not only consistent and accountable care, but also care that is connected to our broader health system," Rachel said.

CareOregon described its timeline and outreach. The CCO said it first notified impacted associate providers in December 2024, held a listening session in February 2025 and began…