Oregon bill would limit insurers’ audits of behavioral‑health providers, shorten look‑back period

Rep. Rob Noss, a Portland Democrat, and a panel of mental‑health providers urged the House Committee on Behavioral Health and Health Care on March 13 to pass House Bill 2029 to curb insurer and CCO audit practices they say are injuring small behavioral‑health practices and reducing access to care.

"This bill is about audits," Rep. Rob Noss said. He described audits as "part of doing business for providers" but said current practices can be "far reaching, cumbersome, and ... surprising." The bill would require insurers and CCOs to provide plain‑language instructions on how to file claims and explain which documentation problems could lead to recoupment, shorten the general audit look‑back to claims submitted within 12 months and limit look‑backs to six years only in cases of suspected fraud.

The bill would also prohibit statistical extrapolation of findings without clear documentation, bar auditors…