Telehealth has become a lifeline for many people seeking mental health treatment. It’s especially popular for people with depression, who can find it impossible to get out of bed, let alone drive across town to sit in a sad, sterile waiting room. We definitely wouldn’t want the state to accidentally wreck telehealth through Oregon MSO law restrictions.
Oregon Passes Another Law
A cold-eyed bureaucrat walks across the room, her stiletto heels clicking louder and louder. She reaches across Grandma’s bed and slaps the nurse’s hand away just as he’s about to hang the chemo IV. A small child presses her forehead and palms against the glass door outside. “Grandma,” she whispers. A single tear rolls down her cheek.
Is greed good, or bad? The legislature shared some thoughts on the matter in its preamble to SB 951: “the State of Oregon since 1947 has recognized that a conflict exists between the economic imperatives of for-profit corporations and other business entities and the need for patient-centered medical care.” I think that means greed is bad.
So what does SB 951 do?
It creates a new way to sue people. However, instead of creating a new cause of action to make it easier to sue bureaucrats for interfering with a doctor’s judgment, the law creates a new way for doctors to sue management companies called MSOs. An MSO (management services organization) is a separate business that handles the administrative, non-medical side of a healthcare practice. They are already prohibited from running medical practices on their own. Under the new law, an MSO can’t “own” or “control” more than 50% of a medical practice, either. S.B. 951 §1(2)(a)(A). The law proceeds to define “control” as exercising ultimate authority over things like hiring, setting staffing levels, setting clinical standards, setting prices, setting billing policies, and negotiating contracts with third parties.
That means the statute allows an MSO to handle administrative functions for doctors but prohibits the MSO from having “ultimate authority” over those same functions. In the real world, that distinction makes little sense. “Handling” something usually means making the final decision about it. For example, someone has to set the schedule. If the Dr. does it, what is the MSO being paid to do? If the MSO does it, that risks running afoul of the law.
To be clear, MSOs can and do sometimes pose problems. Supporters of SB 951 lined up to share examples of MSOs s pressuring physicians to see more patients in less time. But the law doesn’t just target this type of bad conduct. It restricts MSO arrangements far more broadly. Instead of cutting back dead limbs, the law swings an axe at the whole for-profit corporation tree.
Wait, aren’t Telehealth Platforms MSOs?
Someone has to build and maintain the platform, schedule patients, standardize billing, negotiate with insurers, and coordinate with clinicians. That’s exactly what many telehealth companies do. Does this mean Oregon SB 951 and the broader Oregon CPOM law telehealth restrictions could effectively limit or even ban certain telemedicine models? While out-of-state platforms may be mostly exempt, in-state and hybrid telehealth services are likely to face serious challenges under these Oregon telehealth restrictions. So while the law doesn’t kill telehealth outright, it does seem likely to limit telehealth growth, which ultimately reduces access. Rural patients and those with chronic disabilities are going to be hardest hit.
“The true hypocrite is the one who ceases to perceive his deception, the one who lies with sincerity.”
— André Gide[1]
Oregon amended SB 951 with HB 3410, supposedly to close some more loopholes. In reality, HB 3410 carefully carved out the largest, most consolidated institutions in the system. HB 3410 exemptions exclude hospitals, hospital-affiliated clinics, long-term care facilities, etc. from the most important prohibitions of SB 951. See HB 3410 §1 (amending SB 951 § 1(3)(e)(F)–(H)). The whole point of the Oregon MSO law was, supposedly, to stop non-physicians from controlling clinical decisions. But hospital administrators already do that every day. Tightening the rules on MSO partnerships while exempting hospitals undermines independent clinics ability to compete and seems likely accelerating consolidation with huge corporations, the same ones the law identifies as our biggest problem.
Who else stands to gain here?
Until and unless there’s another amendment, enforcement of the law relies on private lawsuits. SB 951 § 1(5)(b), as amended by H.B. 3410. The statute allows injunctive and equitable relief independent of damages and authorizes attorney fees. What would this type of litigation actually look like, though?
Update:
A federal court case in Eugene provided the first major test of SB 951 this month (May, 2026). It showed the law has real strength. Eugene Emergency Physicians successfully challenged PeaceHealth’s plan to replace them with Georgia-based MSO ApolloMD. Although SB 951 contains a carve-out for hospitals like PeaceHealth, the carve-out only covers it’s own actions. PeaceHealth was attempting to hand effective control of the emergency physician group to someone else — an outside for-profit management company. After the judge expressed strong skepticism about the legality of the arrangement during evidentiary hearings, PeaceHealth dropped ApolloMD and renewed its contract with Eugene Emergency Physicians. This early ruling clarifies that SB 951 blocks third-party corporate staffing schemes even when a hospital is involved.
The case also offers important signals for the future of telehealth in Oregon. The Court enforced SB 951 against a hospital, favoring independent providers more aggressively than many expected. Oregon providers offering virtual services will have more autonomy and less competition. However, the law’s structure appears to favor large national telehealth companies over Oregon-based providers who want to grow or partner with management services. The ultimate impact on telehealth availability remains to be seen.
[1] Gide, a Nobel laureate, became known for writing openly about homosexuality at a time very few people dared to do so. And his 1920’s memoir, Si le grain ne meurt, memorably recounted his unhappy childhood and described how one of his bullies had his friends pin him down and rubbed a dead cat he had picked out of the gutter directly into his face. Gide is also remembered for having rejected the manuscript of Marcel Proust’s first book. Proust eventually published Swann’s Way at his own expense.