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Last month, WW reported that the Oregon Health Authority would issue rulemaking in early 2025 that would bar therapists in training from billing Medicaid if they work independently of a Medicaid-contracted clinic.
The proposed change met strong pushback from the mental health workforce, which noted that such therapists, called board-registered associates, often have the highest volume of Medicaid patients. Not allowing them to bill Medicaid would leave thousands of low-income patients without a therapist this year, practitioners argued.
In a Dec. 5 letter, CareOregon had said it would stop accepting reimbursement requests from associate therapists on July 31, 2025. OHA in its announcement did not originally set a specific date.
Now, however, OHA says its rule won’t take effect until June 2026.
“The quality assurance is the reason for the change,” wrote OHA leaders to various providers in a Jan. 15 memo about the upcoming rules. “OHA wants to ensure all behavioral health services meet the same standards across the state when public funds are being utilized.”
Agency director Dr. Sejal Hathi wrote in a Dec. 10 report that such a rule change would ensure that associates work at nonprofit clinics and public providers, which struggle to retain mental health professionals, rather than enter more lucrative private practice right after completing their schooling. Hathi said the rule change would ensure that “this critical workforce pipeline is directed toward our highest-need and highest-acuity settings in the state.”