Comparison of HB 3725, HB 2029, HB 4130, and SB 0951

I. Overview of Each Bill

1. HB 3725 (House Bill 3725)

   • Modifies claims processes for healthcare providers and insurers.

   • Adjusts utilization review requirements for behavioral health care providers.

   • Introduces a behavioral health care ombudsman.

   • Claims to enhance mental health parity but lacks safeguards to protect independent mental health providers​ HB3725.

2. HB 2029 (House Bill 2029)

   • Limits how insurers, the Oregon Health Authority (OHA), and Coordinated Care Organizations (CCOs) conduct audits.

   • Establishes strict requirements for audits of behavioral health providers.

   • Mandates clear disclosure of audit criteria to providers​ HB 2029.

3. HB 4130 (House Bill 4130)

   • Restricts non-physician corporations from controlling professional medical corporations.

   • Prevents removal of physician officers and directors without majority physician vote.

   • Prohibits non-compete clauses for physicians unless they are owners of the contracting entity​HB 4130.

4. SB 0951 (Senate Bill 951)

   • Prohibits management services organizations (MSOs) from controlling medical practices.

   • Prohibits non-compete and non-disparagement agreements in medical contracts.

   • Declares that violations of its provisions constitute an unlawful trade practice​ SB0951.

II. Advantages and Protections for Medical Care Providers

• HB 4130 and SB 0951 offer the strongest protections for independent medical practitioners, especially physicians, by limiting corporate interference in clinical decision-making and ownership.

• HB 2029 provides protections to behavioral health providers by preventing abusive audit practices, ensuring clearer documentation standards, and prohibiting retroactive financial penalties.

• HB 3725, while marketed as improving behavioral health reimbursement processes, fails to address key financial risks for providers, creating a framework that could disproportionately favor insurers​House BIll 3725 - A Tro….

III. Disadvantages and Inconsistencies for Mental and Behavioral Health Providers

• HB 3725 lacks provisions ensuring fair compensation and enforcement mechanisms for mental and behavioral health parity. It does not mandate increased provider reimbursement parity or protections against insurer abuses​

• HB 2029 compared to HB ….

• HB 4130 and SB 0951, while beneficial to physicians, do not explicitly include behavioral and mental health providers, leaving those professions exposed to potential corporate control and unfair contracting practices.

• HB 2029 offers specific audit protections for behavioral health providers but does not address broader financial risks such as claim denials, network exclusion, or rate manipulation.

IV. Failure to Address Allegations Challenging Moda Health

The MRI complaint against Moda Health alleges:

1. Fraudulent and unfair contracting practices which expose providers to undefined financial risks.

2. Phantom networks that deceive purchasers by listing unavailable providers.

3. Retaliation against providers who challenge contracts and lack of whistleblower protections​ 2024-27-10 Complaint Ag….

How the Bills Fail to Address Moda Complaint Issues:

• HB 3725 does not contain enforcement provisions against fraudulent contracting, phantom networks, or retroactive claim denials. Instead, it may increase insurers' power over behavioral health reimbursement without proper accountability​House BIll 3725 - A Tro….

• HB 2029 provides protections against audit abuse but does not explicitly restrict the kind of financial manipulation and retroactive penalties alleged in the Moda complaint​. HB 2029.

• HB 4130 and SB 0951 limit corporate control of medical practices, but their lack of focus on behavioral health providers allows companies like Moda Health to continue unfair contracting under managed behavioral health care agreements​ HB 4130​ SB0951.

V. Comparison Table

V. Conclusion

While HB 2029, HB 4130, and SB 0951 provide some protections for medical providers, HB 3725 actively creates loopholes that benefit insurers while failing to protect mental and behavioral health providers. None of these bills directly prevent Moda Health’s fraudulent contracting or offer meaningful recourse for affected providers.