Our Mission
WOMHA is a multi-disciplinary independent practice association that supports the evolving needs of behavioral health professionals in Oregon. We assess and promote the practical and legislative needs of individual practitioners and practitioner owned behavioral health groups.
We strive to provide accessible, accountable, and effective services to our clients. We offer professional education to our membership and the larger professional community. We aim to be an inclusive organization and are committed to fostering a respectful and welcoming environment for all.
WOMHA engages in legislative and political action to protect and strengthen Oregon behavioral health services as an integral part of the larger health care community. We advocate for the broadest application and enforcement of federal and state mental health parity laws in order to de-stigmatize mental health disorders, promote functional health of mind and body, and reduce mental health disability within the Oregon population.
Our History
Background
Oregon has historically experienced aggressive efforts by insurer managed care to restrict behavioral health services and reimbursements. This threat stoked fear and insecurity in behavioral health professionals who worried their livelihoods would be at risk if they contracted with health insurance companies. That fear was realized in 2009 when Regence drastically cut mental health reimbursement rates; behavioral health professionals were left with the difficult choice to absorb the drastic cut to their pay or leave the network which would reduce public access to behavioral health care.
2013
Nick Dietlein, the founder of our association, attended a workshop with the American Mental Health Association which inspired him to form the Western Oregon Mental Health Alliance (WOMHA) Steering Committee. This committee was eventually known simply as WOMHA, and became the second behavioral health independent practice association (IPA) in the nation.
2014
WOMHA advocated for state legislation to achieve fair pay for Oregon behavioral health providers. This initial legislation effort faced significant hurdles and ultimately failed in 2015.
2015
WOMHA developed and secured negotiated insurance contracts with Moda and PacificSource based on their "Connecting Care Model" which promoted feedback informed care and collaboration with physicians.
Regence drastically decreased behavioral health reimbursement rates for independently contracted providers again, with the deepest cuts for CPT code 90837. This move coincided with other insurers also targeting 90837 for reimbursement reductions and increased utilization review, putting pressure on behavioral health professionals to avoid providing or billing 60-minute psychotherapy sessions.
2016
WOMHA surveyed licensed behavioral health professionals in Oregon and discovered nearly half had left or were planning to leave insurance panels due to low reimbursement and aggressive utilization reviews. In other words, the cost containment strategies used by insurance companies to squeeze behavioral health providers were having a clear downstream negative effect on consumers by decreasing access to care. The question was what to do about it.
WOMHA member Patrick Mooney proposed an innovative solution based on state and federal mental health parity laws that extended the concept of parity to reimbursement rates. This validated comparing behavioral health reimbursement rates to medical/surgical reimbursement rates as a metric for identifying whether an insurer was in compliance with mental health parity laws. If state regulators required insurers to produce data that allowed these comparisons, it would expose the worst offenders.
To get the job done WOMHA formed the Oregon Independent Mental Health Professionals (OIMHP), a committee dedicated to state-level legislative advocacy. Pat's concept was drafted into a bill and proudly introduced to the Oregon legislature as Senate Bill 860 "at the request of the Oregon Independent Mental Health Professionals."
SB 860 required commercial insurers to produce data on reimbursement rates and utilization review practices for behavioral health and medical/surgical, allowing for comparisons which would be compiled into a publicly available report.
2017
OIMHP advocated for SB 860 with the help of lobbyist JL Wilson, founder of Public Affairs Counsel. Their grassroots campaign garnered an incredible 151 emails and testimonies in support of the bill, grabbing the attention of Oregon legislators who voted to pass SB 860 which was signed into law on August 8th, 2017 by Governor Kate Brown.
The passage of SB 860 was a significant victory for all mental health providers in Oregon and provided irrefutable evidence that WOMHA's legislative advocacy strategy was effective.
2018-2020
WOMHA met quarterly with the Department of Consumer and Business Services (DCBS), the state regulators overseeing health insurance, to monitor and advise them on the data collection and reporting process required by SB 860.
DCBS released their findings in a SB 860 Status Report, and OIMHP provided DCBS with a thorough appraisal of the methods and analyses, highlighting strengths and areas for improvement.
2020-2021
WOMHA and OIMHP joined other stakeholders to form a coalition inspired by the 2019 Wit vs. United Behavioral Health (UBH) class action lawsuit, which was decided against UBH and exposed the magnitude of inappropriate insurance practices aimed at reducing quality of and access to behavioral health care. However, the Wit decision only applied to members of the lawsuit and would not change the system unless legislation was passed and signed into law.
OIMHP crafted language and concepts that became a part of Oregon House Bill 3046, legislation designed strengthen mental health parity laws by requiring insurance companies and CCOs to report to the state on their own parity compliance. The bill also made explicit that parity applies to reimbursement and solidified comparisons between behavioral health and medical/surgical reimbursement as a valid metric.
WOMHA and OIMHP joined forces with COPACT and NAMI-Oregon to lobby for HB 3046, which successfully passed and was signed into law by the governor on August 27, 2017. This law was truly groundbreaking, being the broadest state-level effort to strengthen mental health parity in the country at the time of passage.
2021-2022
Once a bill is passed, the next stage is rulemaking which is a process to decide on how the provisions of the bill will actually be implemented in practice. State regulators invite stakeholders and experts to advise them as members of an official committee.
OIMHP was invited by DCBS to send a representative to serve on the HB 3046 Rulemaking Advisory Committee (RAC), marking the first time OIMHP was offered a seat at the table.
Member and future WOMHA Board President Melissa Todd served on the HB 3046 RAC on behalf of OIMHP. She was the only practicing behavioral health provider, putting her in a position to prevent insurance company representatives from dominating the rulemaking process. She fought against insurer efforts to weaken and water down behavioral health parity reporting requirements and successfully influenced the rules that were eventually adopted by DCBS in 2021 and 2022. See OAR 836-053-1405 and OAR 836-053-1430.
2025
Two bills OIMHP supported passed and were signed into law. OIMHP was invited to sit on the rulemaking advisory committees for both SB 824 (Behavioral Health Parity reporting) and SB 822 (Network Adequacy), again sending WOMHA Board President Melissa Todd to advocate on behalf of behavioral health professionals and consumers of behavioral health care. We anticipated these RACs to be uneventful, but insurers are always looking for ways to weaken bill language and decrease regulatory oversight.
See this example of OIMHP advocacy on the SB 824 RAC to call out insurance company efforts to limit DCBS's regulatory scope and keep important information hidden from the public.
Future
WOMHA remains committed to our efforts to strengthen mental health parity laws and enforcement efforts in Oregon, making it more tenable for behavioral health professionals to join and remain on insurance networks. We believe people should be able to use their insurance to access behavioral health care and behavioral health providers should be treated fairly by insurance companies.
OIMHP has developed legislation to introduce in 2026 which reforms state laws on audits and clawbacks, and extends behavioral health parity reporting to metrics designed to expose CPT code 90837 suppression.