CareOregon, the largest Medicaid provider in the state, will soon stop covering mental health and substance use treatment from out-of-network providers. Coverage will end on Oct. 1 for Medicaid members and on Jan. 1 for members of Medicare Advantage. The decision will disrupt care for an estimated 15,000 patients, or about 15% of the organization’s members who use behavioral health services. The organization says the changes will bring it back into alignment with industry best practices after making provisions to expand access to mental health care during the COVID-19 pandemic.
Amit Shah is the chief medical officer at CareOregon. He joins us with more details about the decision.
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