Important Insurance Update for Providence Members
Dear friends,
It breaks my heart to leave this network. But I will not break my promise to offer care that’s rooted in integrity.
As of September 1, 2025, I will no longer be in-network with Providence commercial insurance plans.
As of January 1, 2025, I will no longer be in network with Providence Medicare insurance plans.
This change may include some self-funded plans like Intel and PEBB, depending on whether they adopt ASH’s system. If a plan remains administered directly by Providence (without outsourcing to ASH), I may still be considered in-network, but if it transitions to ASH at any point, I will be out-of-network.
As of January 1, 2025, I will no longer be in network with Providence Medicare insurance plans.
(This change does not apply to those of you with OHP/Providence Medicaid (called Providence Health Assurance)).
I did not make this decision lightly. Providence recently and suddenly announced it will hand over all acupuncture benefit management to a for-profit company in Indiana called American Specialty Health (ASH). This shift means that:
All acupuncture treatments must be pre-approved through a prior authorization process, even for conditions already being treated.
I would be required to submit extensive documentation for authorizations and medical necessity reviews to this private company for medical necessity reviews, which I believe raises serious concerns about privacy and data security.
At the same time, my reimbursement rate will be cut by 50–70%, while the administrative burden significantly increases, both for me and for the biller I work with (which means I also have to pay more just to process claims).
For a small clinic like mine, this model is especially unsustainable. It would cost me money to continue providing care under these new terms, especially in Portland where small business taxes and cost of living are among the highest in the country. As much as I wish I could offer my work as a service of love alone, I also need to survive.
To preserve both the quality of your care and the viability of my practice, I will be moving out-of-network with all Providence commercial, Intel and PEBB plans as of September 1 and out-of-network with Providence MedicARE plans as of January 1, 2026. At this time, I remain in-network with OHP Providence Health Assurance.
What Does This Mean for You?
If you have Providence commercial insurance and wish to continue working with me:
You can still receive care, but my cash rate of $90 per visit will apply.
If you want to pursue reimbursement through Providence, I can provide a superbill (a special receipt with treatment codes).
However, Providence (through ASH) now requires that we first obtain prior authorization before you submit any superbills.
This process includes submitting your confidential health records for review by this private third party company, and can take time, with no guarantee of approval.
Even if approved, reimbursement is typically much lower than the amount you’ll pay upfront and only for select services they deem "medically necessary."
ASH does not cover important parts of your treatment such as cupping, gua sha, tui na massage, or moxibustion. These therapies are often integral to your care and uncompensated by ASH.
I’m truly sorry that Providence’s decisions are creating these obstacles for your care. If this change feels frustrating or unjust, you are not alone and you do have a voice. You can contact Providence and other organizations to advocate for yourself and your providers. (See below for resources and templates.)
Why Is Providence Doing This?
Providence claims this change will "streamline care" and "improve quality," but the true motivation is cost-cutting and patients and small providers are bearing the cost.
While cutting payments to providers and shifting administrative work onto us, Providence’s top executives are earning millions:
CEO Rod Hochman was paid $5.1 million in 2023, even as Providence reported major losses and cut costs across departments.
Multiple other executives earn $1–4 million per year, despite Providence’s tax-exempt nonprofit status.
Providence has come under national scrutiny, including in a New York Times exposé (Kliff & Silver-Greenberg, 2022), for aggressive debt collection from low-income patients while maintaining massive executive salaries.
Source: Kliff, S. & Silver-Greenberg, J. (2022). "They Were Entitled to Free Care. Hospitals Hounded Them to Pay." The New York Times.
This move to ASH is not about improving care. It’'s about outsourcing "utilization management" to reduce costs, deny care, and make patients and providers do more work for less.
What Can You Do?
You have the right to high-quality care and to speak up when that care is put at risk. If you’re impacted by these changes, here are some meaningful ways you can take action:
1. Contact Providence
Let them know how these changes affect you as a patient. You can share your personal experience, express concern about prior authorizations, reduced access, or having your private records reviewed by a third-party corporation.
2. Talk to Your Employer’s Benefits Manager
Many Providence plans, like those through Intel or the PEBB (Public Employees' Benefit Board), are self-funded. That means your employer has the power to push back against this ASH transition. Ask them to review the decision and consider restoring direct provider contracts.
3. File a Complaint with the Oregon Division of Financial Regulation
If you believe your access to care is being unfairly limited, you can file a formal complaint with the state. They regulate insurance companies and can investigate whether these changes violate consumer protections.
4. Contact Your State Legislators
Let your representatives know how corporate gatekeeping is harming your ability to receive timely, affordable care. Oregon has laws intended to prevent discrimination by provider type. Your voice helps ensure they’re enforced.
5. Share With Others
Many patients are unaware of this change. You can help by sharing your experience, forwarding this information, and inviting others to advocate alongside you. There is even a petition going around that you can sign.
Sample Letters Available For:
If this change feels heartbreaking or unjust, you are not alone. I will continue to do everything I can to provide care in a sustainable way and support you in advocating for your health.
I may be stepping out of the network, but not away from you. I’m here. I’m here.
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