Gov. Tina Kotek considers a new pressure campaign waged by Montana-based telehealth firm to be “misleading,” according to a spokesperson, even as more people weigh in on what level of oversight is appropriate for virtual mental health services offered by providers not licensed in Oregon.
Charlie Health, a national for-profit firm backed by private equity, has launched a “Save Virtual Care” campaign calling on people to write to Kotek because the company is concerned that the Oregon Health Authority will not renew its certification to continue work in Oregon under a program allowing use of unlicensed providers.
Agency officials have pushed the company to stop using the program, saying the company’s lack of in-person services makes it harder to provide oversight to ensure quality care. The company’s spokespeople, however, say the agency is being unfair.
In response to the campaign, some mental health providers have portrayed the campaign as misleading, since Charlie Health could easily continue offering telehealth services by only using providers who are licensed in Oregon. Kotek echoes that message.
“These ads are misleading — virtual care is not being eliminated in Oregon,” a spokesperson said in an email.” The Governor supports the use of telehealth in Oregon which has helped increase access across the state. To ensure quality of care, the Oregon Health Authority has a ... review process to ensure behavioral health organizations that are serving clients with Medicaid are providing appropriate oversight and supervision of staff providing care. This is an important measure that helps to maintain the quality of care.”
A company spokesperson wrote in an email that the company's existing services have a “track record of outcomes equal or superior to brick and mortar care.” He added that if the company decides to stop offering telehealth due to being required to use Oregon-licensed providers, rural residents in need of care could have “no option but to drive two or three hours a day several days a week.”
He said that competing providers' loss of revenue was behind the state's push to require Oregon-licensed providers for Charlie Health. “We won’t let that happen to our patients. We will fight for them in the court of public opinion. We will fight for them in court. This is too serious for political gamesmanship and Charlie Health is here to stay.”
Mental health spending scrutinized
The issue has arisen even as insurers and the state are grappling with the realization that the state has spent untold millions on a state initiative intended to boost behavioral health access under the Medicaid-funded Oregon Health Plan, but did not ensure services went to folks most in need of it.
Higher reimbursements may have helped to improve the state’s national ranking in mental health, but lawmakers and other health care observers say the program lacked rules to focus assistance on people with serious needs as opposed to a desire for “talk therapy.”
To address the resulting lack of funds, state officials and several insurers and nonprofits serving lower-income Oregonians have restricted what providers they’ll employ while drastically cutting reimbursement rates, pushing some to raise concerns over whether they could continue serving people in need. In Lane County, one insurer that lost millions due to higher-than-expected behavioral health spending, PacificSource, has pulled out of serving members of the Medicaid-funded Oregon Health Plan.
Dueling campaigns
In response to the “Save Virtual Care” campaign operated by Charlie Health, a website called “Safe Virtual Care” has sprung up to defend the rules that Charlie Health is challenging.
Such campaigns are hardly unheard of. Lawmakers and staffers over the years have described campaigns involving not only emails and form letters but methods using marketing to get people to call a phone number so they can be referred directly to an elected official’s office, often with little knowledge of the issue beyond the advocacy campaign prompting the call.
While both of the websites offer to generate emails to Kotek, only a small number of them have gone to the office’s constituent services inbox, according to a governor’s spokesperson. Three emails obtained under Oregon Public Records Law show two people weighed in against the Charlie Health campaign, and one supported it.
Here are some excerpts:
“Just saw a commercial stating Oregon is looking at removing virtual healthcare. The commercial I saw related to mental health, virtual therapy. My daughter is attending college on scholarships and student/parent loans away from home. She relies on OHP and virtual counseling. She’s a sexual abuse survivor, attended high school during Covid (2018/19 thru 2021/22), suffers from severe ADHD and anxiety. The stress of seeing a local therapist in person with her school schedule and workload was counterproductive. Removing the ability to continue her therapy with the therapist she’s built trust with would be devastating. Please do NOT take away virtual healthcare.”
“I read an ad in The Oregonian about a for-profit, out-of-state, virtual mental health organization that wants to continue being allowed to provide services to the OHP in Oregon. I read more about Charlie Health, and I hope that you use your position to urge the legislature to block unlicensed providers and Charlie Health from dodging oversight. I know firsthand that there is an acute need for mental health providers in Oregon, but Charlie Health is not it.”
“I’m writing as an Oregonian who strongly supports telehealth and wants to protect access to virtual behavioral health care across our state. However, I’m concerned about recent messaging circulating in Oregon that implies telehealth is “at risk” or that the state is “backtracking” on virtual care … Virtual care is not being eliminated in Oregon. What is at stake is whether large, out-of-state telehealth companies will be allowed to operate in Oregon while bypassing Oregon’s basic patient safety standards—such as Oregon licensure requirements and appropriate oversight from the Oregon Health Authority.”
