CareOregon/Columbia Pacific CCO to require contracted outpatient behavioral health providers; change already in effect for board‑registered associates

CareOregon and Columbia Pacific Coordinated Care Organization (CPCCO) officials told the Clatsop County Board of Commissioners that two behavioral‑health policy changes — a board‑registered associate billing change effective Aug. 1 and a requirement that routine outpatient mental‑health and substance‑use‑disorder (SUD) services be delivered by contracted providers effective Oct. 1 — are intended to improve quality, oversight and care coordination for Medicaid members.

The presentation said the board‑registered associate policy already took effect Aug. 1 and that the contracted outpatient network policy will go live Oct. 1. Rachel, a CPCCO presenter, said the changes are designed to align CareOregon with managed‑care industry standards and with a longer OHA (Oregon Health Authority) rule‑making timeline that may culminate in June 2026. “We are asked really to do more with less,” she said, and the policies aim to prioritize providers able to deliver team‑based, credentialed services for members with the most complex needs.

CareOregon and CPCCO told the board they began outreach and assessments in December 2024 and stepped up proactive contracting and member notifications this summer. Rachel said CareOregon offered contracts to non‑contracted providers who met region‑ and county‑specific thresholds; in some rural cases the threshold for offering a contract was as low as two members served in the prior year. She said the network assessment showed that about 19% of outpatient behavioral‑health providers are non‑contracted but account for only about 6% of outpatient utilization, and that roughly 500 members across Clatsop, Tillamook and Columbia counties could be affected without mitigation.

The presenters emphasized workforce and access concerns and described supports for contracted providers, including credentialing assistance, Medicaid billing training and value‑based program technical help. Rachel also said CareOregon will continue a proactive contracting process after Oct. 1, maintain a “panel status” option for culturally and linguistically specific services (CLSS) providers and perform direct outreach to high‑risk members to reduce care disruption. “We are engaging in a continual assessment of our members’ needs, our network needs, and filling gaps where we can,” she said.

County commissioners pressed presenters on several areas. Commissioner Webb asked about language and race impacts; Rachel said the internal equity assessment showed English‑speaking and white adult members were disproportionately affected in aggregate, but that American Indian and Alaska Native members were impacted at a rate that deserved targeted outreach — “about 8% of our members there are impacted by this change,” she said, while they represent roughly 2% of the CCO population. Commissioners also asked for detail and documentation on reported higher rates of fraud, waste and abuse among non‑contracted providers; Rachel said that review of providers who requested contracts allowed CareOregon teams to examine claims and documentation and that some themes of higher fraud, waste and abuse emerged in the non‑contracted cohort.

Commissioners and presenters discussed licensure and the administrative burden of obtaining a COA (certificate of approval). Shaira, speaking as a COA representative and a participant on the governor’s talent council committee, confirmed the COA and licensure processes are time‑consuming and said the committee is working with licensing boards to reduce burden. Commissioners said pay disparities and licensure barriers limit recruitment to rural Oregon and urged continued advocacy with OHA and the governor’s office.

The CPCCO presenters did not propose a formal county action; they said CareOregon is already offering contracts, performing outreach and tracking OHA rule‑making so they can align policies if state rules change. Commissioners asked county staff and the CCO to continue coordination and to make data available for local stakeholder review. Commissioner Thompson requested that CareOregon follow up with HSAC and other community groups to make underlying data available for independent review.

Clatsop County officials and the CCO agreed to continue outreach to impacted members and to monitor access and utilization metrics after Oct. 1. The presenters repeatedly framed the changes as network‑quality and accountability measures rather than an intent to reduce services. The CCO said single‑case agreements for medically necessary services — short‑term negotiated contracts for services not covered by standing contracts — will remain available.

The board took no formal vote during the presentation; staff and presenters said they would continue coordination and follow up with additional documentation and contracting offers to affected providers.