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Legislators press Charlie Health and OHA over use of unlicensed providers and oversight
Summary
During testimony on HB 4,070A, lawmakers questioned Charlie Health's use of out‑of‑state unlicensed providers, the authorship of its outcome studies, and whether OHA's Certificate of Approval covered those practices; OHA said it is reviewing the COA and Medicaid will investigate any improper billing.
Lawmakers pressed company and state health officials on Feb. 26 about whether telebehavioral‑health providers operating under Certificates of Approval (COAs) have appropriately complied with Oregon licensing and billing rules.
Chris McClellan, representing Charlie Health, described the company’s virtual‑first model and said the firm operates under an OHA Certificate of Approval that was granted in 2021 and renewed in 2023 after in‑person surveys. He asserted that Charlie Health maintains oversight, supervision and quality‑assurance processes and said the company would share third‑party studies verifying virtual high‑acuity behavioral‑health outcomes.
A committee lawmaker challenged the independence of the published studies, saying they listed authors with financial ties to Charlie Health and asking whether independent academic reviews exist. McClellan responded that some published analyses include Charlie Health data but that there are third‑party studies on virtual high‑acuity care and he offered to provide citations.
The committee also focused on whether unlicensed staff categories (qualified mental health associates or qualified mental health professionals) could provide high‑acuity care and whether an inpatient facility could rely entirely on out‑of‑state telehealth clinicians. John Collins, Deputy Director of OHA’s Behavioral Health Division, said those unlicensed roles are certified categories (QMHA/QMHP) tied to organizations that hold COAs and are subject to state regulatory authority; he added that appropriateness depends on individual clinical needs and that licensed clinicians providing virtual care must also hold Oregon licenses. When lawmakers asked whether OHA intended to renew Charlie Health’s COA, Collins said OHA is reviewing the renewal application and will evaluate compliance with current Oregon laws and rules.
Kristen Don Hefner, Behavioral Health Policy Manager in OHA’s Medicaid division, told the committee that Medicaid has processes to investigate improper billing, adjust claims, recoup payments and escalate enforcement when necessary; she said she would follow up with specifics about the COA review and any billing inquiries.
Committee members said their concern is not telehealth itself but ensuring high‑acuity patients receive care from appropriately licensed clinicians and that agencies enforce existing rules and protect Medicaid funds. The public‑hearing portion closed before the committee adopted an amendment that delays the implementation date for reimbursement eligibility and forwarded the bill to the floor.
