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Pediatric practice and psychologists press for payment parity between medical and behavioral providers; insurers warn of cost and market impacts
Summary
Pediatric practices and psychologists told the committee House Bill 2041 would require insurers to reimburse mental-health professionals at the same rate per RVU as physicians when they perform the same service. Pediatric leaders argued pay parity would help recruit behavioral-health staff and improve access; insurers cautioned about
Representative Rob Nos and pediatricians described challenges recruiting behavioral health staff in integrated primary-care settings because insurer contracts often pay physicians and behavioral-health clinicians different rates for similar services. House Bill 2041 (dash-1 amendment) would require health insurers to reimburse mental-health professionals at the same rate per relative value unit (RVU) as physicians for the same service.
Dr. Peter Reid of Pediatric Associates of the Northwest told the committee that Medicare RVU assignments reflect relative inputs and that historic insurer discounts for psychologists and other behavioral-health providers create network participation gaps. He said in some contracts psychologists are paid 40–50 percent of physician RVU rates, which discourages participation and reduces access. The Oregon Psychological Association (OPA) told the committee it supports the bill’s intent but wanted more analysis of RVU and Medicare benchmark approaches and stronger enforcement mechanisms for parity.
Insurers and benefit directors cautioned that mandating fee-for-service parity by provider class would increase costs, could spur requests for parity across other provider groups and argued for encouraging value-based arrangements instead. Moda Health’s witness provided an actuarial estimate that the bill could increase reimbursement levels substantially and noted the potential impact on premiums, especially in the individual market. Health plans urged careful study and stronger enforcement tools for parity compliance rather than a statutory rate floor.
Why it matters Behavioral-health workforce shortages affect access to mental-health care. Sponsor and provider witnesses argued payment parity would motivate more behavioral-health providers to participate in insurance networks, improving access. Payers warned a statutory parity mandate could raise costs and asked for alternatives such as value-based contracting and improved enforcement of existing parity statutes.
