Oregon providers advocate for Ombudsman office to resolve insurance compliance issues

May 29, 2025 | Behavioral Health and Health Care, House of Representatives, Committees, Legislative, Oregon


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Oregon providers advocate for Ombudsman office to resolve insurance compliance issues
A proposed Ombudsman office aimed at improving mental health care access took center stage during the Oregon House Committee on Behavioral Health and Health Care meeting on May 29, 2025. Providers voiced urgent concerns about the current system's inefficiencies, particularly regarding the credentialing process and the lack of support for both practitioners and patients navigating insurance issues.

Amber, a provider representative, highlighted the frustrations faced by practitioners when trying to credential new providers, noting that the Department of Consumer and Business Services (DCBS) often fails to meet the statutory requirement of credentialing within 120 days. "I have providers personally that I've been trying to credential for over six months," she stated, emphasizing that delays directly impact patient care.

The discussion revealed a significant gap in the current regulatory framework, with providers caught in a "weird middle ground" where they lack the protections afforded to both consumers and traditional businesses. This situation leaves them unable to advocate effectively for their patients, many of whom struggle with medical literacy and feel overwhelmed by the complexities of insurance claims.

The proposed Ombudsman office would serve as a dedicated resource to address these issues, allowing providers to report complaints and seek assistance without fear of retaliation from insurance companies. "We need to be able to advocate for our patients," Amber stressed, suggesting that integrating this office into the Oregon Health Authority could streamline processes and enhance accountability.

Committee members expressed interest in the proposal, recognizing the potential for increased transparency and improved compliance with existing mental health parity laws. As the meeting concluded, the call for action was clear: establishing an Ombudsman office could be a crucial step toward alleviating the burdens faced by both providers and patients in Oregon's behavioral health landscape.

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