Oregon providers press lawmakers for ombuds office to address insurer audits and parity gaps

PORTLAND, Ore. — Behavioral health providers told the Oregon House Committee on Behavioral Health and Health Care on May 29 that insurance audits, retroactive payment clawbacks and unclear enforcement of parity law are imposing severe operational and financial strain on small practices and are reducing patient access to care.

Providers asked legislators to create an ombuds office empowered to take and log complaints from providers, share that information with regulators and to escalate patterns of insurer conduct for enforcement or legislative fixes.

The request came during an informational hearing on House Bill 2,040 and House Bill 3,725, which the committee opened to hear provider testimony but did not move for action. Tiffany Ketterman, who identified herself as the owner of a group mental health practice with 45 staff that serves more than 800 clients and provides over 2,300 monthly appointments, described repeated audits and a “never ending threat to my personal financial stability.” She said, “It is by far the most exploitative, difficult, exhausting, stressful work…