Read & Sign the Healthy Contracts Petition!
The “signable” petition is presented in a series of small sections before you are asked if you want to sign it.
A copy of the petition is available for review below the example endorsements.
Example Endorsements
As a psychologist in private practice for 22 years and who has served the public in the field for 35 years, I strongly endorse this petition.
My experience engaging with insurance companies on behalf of my patients has been at best neutral, and at worst, it has been aversive, ethically questionable and harmful to patient care.
Some examples:
**I am not alone in having counseled patients with chronic and severe mental health conditions who were clearly benefiting from evidence-based care, but who had their coverage for my services drastically reduced or cut off entirely, based on health insurance audits using vague or undefined "medical necessity" criteria. The insurance companies' appeal procedures were overly complex and time-intensive, and therefore felt too intimidating for my clients to pursue.
**Some current Oregon behavioral health insurance contracts are mandating that providers document treatment via electronic health records that are not necessarily accessible or affordable for all. In my opinion, that is counter to diversity, equity and inclusion ((DEI) principles, at minimum.
**Some insurance companies are inadvertently incentivising certain services that differ only in location code (telehealth or in-office) by compensating mental/behavioral health providers differently for these codes. This negatively trickles down to members in that they may end up paying higher or lower coinsurance amounts for identical telehealth or in-office sessions. It also creates inequity in that different "usual and customary" fee amounts are then applied to patients' deductibles, based on these location codes. As a result, it might take longer for members to meet their deductibles, should they need or prefer to meet with their providers exclusively in-office or via telehealth. To my knowledge, there is no way to question or report this practice. It appears unregulated in that each insurance company has its own policy, which is not proactively shared with plan members or providers.
Historically there has been no oversight that effectively and fairly protects both patients and mental/behavioral health providers, ensuring optimal access to effective treatment. This petition is a critical step in the right direction.
Heather L Stein, PsyD
Licensed Psychologist, Oregon
https://www.heatherdoc.com
____
I support this concise and very thorough petition. I really appreciate all who contributed to this meaningful document. Keep me posted on the next steps and let me know how I can support this petition besides signing it, which is done.
Warm Regards, Janiene
Janiene Beauchene JD, LCSWBeauchene Family Therapy LLC
____
That is a powerfully written petition, which names the risk to the public if Health Plans aren't held accountable. I really like the visual at the beginning with the red, yellow and green too. It shows how crazy making it is for counselors to try to be in practice and impossible to practice while feeling secure. It also shows how it doesn't have to be that way. I also really like how it lets you see your answers after signing. Thank you for sharing this with me and for all of the work that has gone into it!
Ember Von Letkemann
https://www.psychologytoday.com/us/therapists?search=Ember+Von+Letkemann
____
As a board member of Mentor Research Institute, former internal auditor, and concerned human being, I am pleased to endorse this petition. As the healthcare industry continues to undergo significant and continuous change, it is critical that changes in the complex mental and behavioral health segment of this industry be structured for the best possible patient outcomes. This petition calls for improvements to the payor: provider contract engagement and oversight to establish clear and measurable requirements, to ultimately ensure that patient-focused treatment benefits are available and accessible in healthcare plans. The most advantageous approach to accomplish this involves a collaborative relationship between payor and provider to establish clear and measurable contract requirements which:
align with best practice clinician treatment recommendations.
hold the clinician as the treatment expert.
fairly compensates the clinician for all services while keeping all parties financially sound.
appropriately protects the payor, provider, and patient.
This petition and its intended legislation set a precedent in mental and behavioral healthcare models. Let’s not complicitly allow a lower standard. Join me in support of better healthcare in Oregon by adding your name to the petition.
Patsy J. Cobb
https://www.mentorresearch.org/about
Patsy J. Cobb is retired Director of Audit & Risk for Northwest Evaluation Association (NWEA) which has its main office in Portland, OR and a regional office in New York, NY. At NWEA she was responsible for internal audit functions and risk management oversight, with emphasis on information security, infrastructure development and staff self-sufficiency through education and training. From 2000 to 2006 Ms. Cobb was Director of Finance for NWEA serving on the management team which grew that 501(c)(3) non-profit organization (specializing in educational assessment, psychometric research, proprietary software development and application service provider) from $4.5 million to nearly $50 million in annual revenues, with a proportionate growth in the number of clients served.
Copy of the Healthy Contracts Petition
A complete copy of the Healthy Contracts Petition is below for those who want to review the petition before signing this vital document.
The focus of the proposed legislation is to protect providers’ practices, improve access to mental and behavioral healthcare, to protect public health and to support the values of mental and behavioral health practices of all types and sizes. You will be able to download a complete copy of the Petition with your signature.
Provider practices (hereafter providers) do not have the legal and financial resources to challenge inappropriate, unethical, harmful or unconscionable contract and audit requirements.
We need legislative action to… (1) ensure that provider practices can hold an ethical line to protect patient health and well-being, and (2) ensure Healthplans offer contracts that support provider clinical judgement, which are patient-centered, and do not result in undertreatment.
We need legislative action to… (1) Prevent Healthplans from offering contracts that intimidate and alienate mental health providers, (2) create a confidential process for providers to report their concerns to an accountable committee of licensed peers, and (3) establish processes to audit Healthplan contracts, policies, and practices as it pertains to patients/public health and provider practices.
We need legislative action to… Prevent Healthplans from executing new contracts or changes to contracts until after review by an independent auditor under the direction of a committee of licensed peers. Audit outcomes may demonstrate (1) any detriment to patient/public health, (2) lack of shared values and objectives with providers, (3) hidden or arbitrary Healthplan audit criteria and objectives, (4) ambiguous, deceptive or unconscionable contract requirements, (5) unjustified demand for reimbursement payback, (6) charting and administrative tasks that have limited or no value, and (7) failure to align with evidence based practices necessary to improve outcomes and access to care.
Healthplans are not ensuring care but are actually limiting access due to Healthplan contracts, policies, and audit criteria. Providers currently (1) have little to no visibility into what they are held accountable to do until after they are audited, and (2) have little or no fair recourse to appeal or challenge Healthplan audit criteria, or lack thereof. Healthplan audits that are threatening, unnecessary, incompetent and undermine access.
We need legislative action to… Create a contract audit committee, comprised of licensed peers and Healthplan representatives, to direct a qualified auditor officer who is authorized to audit a Healthplan's audit of one or more providers. The Audit officer will ensure the Healthplan' audit was reliable, valid, useful, fair and conducted in good faith. The audit of the Healthplan policies, practices and behavior may include but is not limited to that which is potentially (1) unethical, (2) not a best practice, (3) not patient-centered, (4) undermines the patient-provider therapeutic relationship, or (5) threatens patient lives or public safety.
Mental and behavioral health provider practices in Oregon are the first to identify Healthplan policies which waste clinician time and reduce access to care. This may include (1) Healthplan practices of using medical necessity criteria as the only justification for services rather than also considering social determinants of health, (2) charting in ways that satisfy Healthplans but waste clinical time and resources; or (3) the use of incentives that primarily benefit the Healthplan to the detriment of patient/public health, and provider practices.
Please share information with colleagues so they can participate in the petition.
Sponsored by independent practice providers, Mentor Research Institute, and the Independent Mental Health Practices Alliance (IMHPA).
Responses will only be used to protect public health and provider practices.
Thank you for your time. Please contact us if you have any questions: www.MentorResearch.Org/Contact-Us