The Care First Administrative Reform Package

June 12, 2026

Clearing the Path to Patient Care: Administrative Reform for Oregon Clinicians

When clinicians spend their days chasing approvals and fighting audits instead of caring for patients, everyone loses. Oregon's clinicians, from family medicine to behavioral health and specialists, from rural practices to community health centers are spending an unsustainable amount of time navigating insurance companies’ administrative requirements and state policy that hinders care. Prior authorizations delay life-saving treatment, billing audits demand repayment years after care was delivered, credentialing processes must be repeated from scratch with every insurer, and documentation burdens keep clinicians staring at screens long after their patients have gone home. On top of that, state-run programs that were originally designed to contain costs and maintain access to care are having the opposite effect and are adding administrative burden and cost to an already strained system. This isn't just a problem for clinicians — it's a problem for every Oregonian who’s ever waited longer than they should for care, struggled to find a clinician who’s still accepting patients, or watched a trusted provider burn out and leave the profession.

The Care First Administrative Reform Package is Oregon's answer. It is a coordinated, coalition-driven legislative initiative targeting the 2027 Oregon Legislative Session, built to clear the way for clinicians to connect with the patients who need them.

The Care First package brings together a broad coalition of clinician organizations representing physicians, behavioral health professionals, dentists, pharmacists, acupuncturists, podiatrists, and more, united around a single goal: reducing the administrative burden that drives patients away from care and clinicians out of practice. Together, we have identified 12 areas where reform is needed. These issues touch every specialty and every corner of Oregon's healthcare system, spanning the full administrative journey from enrollment to payment.

Issue Areas

Prior Authorization

Insurance companies require advance approval before patients can receive care, delaying treatment and consuming staff time. We are advocating for faster decisions, electronic processes, and exemptions for high-performing clinicians.

Provider Enrollment and Credentialing

Clinicians repeat the same enrollment process with every insurance plan they accept. We are advocating for a single, standardized process.

Public Payer Exemption from the Corporate Activities Tax

Clinicians who serve Oregon Health Plan and Medicare patients are committed to keeping care accessible to those who need it most. We support a targeted approach to protect those practices from tax burdens that threaten their existence.

Claims Processing

Non-standardized billing processes create errors, delays, and unnecessary overhead. We are calling for consistency across health plans so clinicians are paid accurately and on time.

HCMO Process Reform

Oregon's Health Care Market Oversight process blocks clinics from forming local partnerships that would improve patient access. We are working to reform the process.

Audit Protections and Clawbacks

Insurers can demand repayment years after care was delivered — sometimes through auditors who are financially incentivized to find errors. We support fair rules, reasonable timeframes, and an end to stacked audits.

Transparency in Medical Management

Behind many insurance decisions is a third-party administrator — a contracted company that conducts audits, restricts billing codes, and delays payment, often with no clear explanation and little regulatory oversight. Clinicians deserve to know who is making decisions about their patients' care and why. We are advocating for greater transparency and accountability.

Parity Enforcement for Behavioral Health

Behavioral health clinicians face management requirements that physical health clinicians do not. We support stronger enforcement of parity laws.

Reporting and Deliverables Burden

Clinicians carry duplicative, time-consuming reporting requirements that add little value. We want to eliminate reporting requirements that do not serve patients.

Shared Administrative Services

The same administrative functions are duplicated across every health plan. We support centralizing shared services and reducing system-wide overhead.

DCBS Enforcement and Clinician Ombudsperson

Clinicians have no dedicated advocate inside state government when disputes arise with insurers. We are urging Oregon to create one.

Reimbursement Rates That Account for Administrative Burden

The true cost of care includes the administrative overhead clinicians absorb. We support rate-setting that reflects that reality.

Note: As part of the Care First initiative, the OMA and a broad coalition of healthcare organizations have created a survey that will help inform our advocacy priorities. We will be asking you to share specific examples and stories — both your own and those of your patients — about how administrative barriers have delayed care, disrupted treatment, increased costs, or affected health outcomes.

Our Coalition

The Care First Administrative Reform Package is led by the Oregon Medical Association and supported by a broad and growing coalition of clinician organizations representing every corner of Oregon's health care system: physical health and behavioral health, specialists and primary care, urban practices and rural communities. Together, we speak for the clinicians who show up every day to care for Oregonians, and for the patients who depend on them.

Organizations interested in joining the coalition can contact Courtni Dresser, Vice President of Government Relations, at [email protected].