Oregon Health Authority begins rulemaking on where associate behavioral health providers may bill Medicaid; advocates warn patients could lose care

Oregon Health Authority officials told the Senate Committee on Early Childhood and Behavioral Health they will launch a formal rulemaking process this fall to consider changes to administrative rules that govern how associate behavioral health providers may bill the Oregon Health Plan. OHA said any implementation would not begin until mid‑2026 to allow time for outreach and adjustments.

The rulemaking follows complaints to OHA about workforce capacity and supervision in high‑acuity community settings. OHA officials said they have received concerns from coordinated care organizations (CCOs), community mental health programs, providers and people with lived experience and intend to collect more input, surveys and listening sessions before drafting new rules.

OHA’s process, Director Emma Sando, Medicaid director, said, “We intend to launch that process in the fall, and, after taking in all of that input over the next several months … we have already provided details that these implementation efforts wouldn't begin until 2026.” Ebony Clark, behavioral health director at OHA, described longstanding concerns about ensuring supervision and safety for people receiving care: “We wanted to really make sure that we were being thoughtful and intentional … assuring quality, safety, and standard.”

Why it matters: advocates and provider groups told the committee that an insurer decision announced in December, and actions already taken by CareOregon, have begun removing access to Medicaid‑paid care for many patients before OHA’s rulemaking begins. Andy Walsh, senior health policy advisor at the Children’s Institute, said data OHA provided to the Oregon Health…