Providence Health Plan Provider Termination: What Ends and When

On October 15, 2026, Providence Health Plan mailed every contracted provider a Notice of Termination of All Providence Provider Contracts. The member pages say when coverage ends; the notice says when your agreements end, what still gets paid and what outlives the contract. Here is each line of business for Oregon and Washington behavioral health programs, and what we would do now.

What did Providence Health Plan's October 15 notice change?

The notice says Providence Health Plan, Providence Health Assurance and Providence Plan Partners, together "PHP," are "discontinuing all lines of business." It ends all provider participation, MCO services, credentialing delegation and other ancillary agreements on their own dates, treats anything tied solely to a terminated line as ended with it unless the notice or the law preserves it, and does not retroactively change payment for services before each date. A copy is on Providence's provider news page.

Our commercial payer map for Oregon and Washington says Providence Health Plan will transition out of most of its lines beginning in 2027 and that provider contracts and network relationships do not change in 2026. Providence's status page, updated in October 2026, still says that, and claims, billing and prior authorizations continue normally throughout 2026. What changed: the notice says all lines of business, not most, and dates every agreement. The Provider Transition FAQ still says there are "no changes to provider contracts or reimbursement arrangements currently." It is stamped October 13, yet its first answer points to the termination letters mailed October 15, so read that line as out of date.

Which Providence contracts end on which date?

The first four columns follow the notice; the last is our recommendation.

Which Oregon and Washington programs are affected?

Every program with a Providence agreement. Four groups feel it first:

• Behavioral Health Network members. The network is named in the commercial termination. Washington programs are in scope too: the notice names WA Choice Individual, and Providence's behavioral health network page lists open panels in Clark, Skamania, Klickitat, Cowlitz and Wahkiakum counties.
• Programs serving Providence Medicare Advantage members. Providence will not offer Medicare Advantage plans in 2027 or beyond.
• Tri-county OHP programs. Providence Health Assurance takes part in Health Share of Oregon, a coordinated care organization serving Oregon Health Plan members in Clackamas, Multnomah and Washington counties.
• Groups with delegated credentialing or an MCO services agreement. Both run a year longer, to January 1, 2028.

Why will most Providence commercial patients be gone before 2028?

Your participation ends January 1, 2028; most of your patients' coverage ends sooner. Providence's status page tells providers that most plans will terminate at the end of 2026:

• Individual and family plans. Discontinued January 1, 2027. Washington's Office of the Insurance Commissioner says Providence Health Plan, which covered 254 enrollees in the state's individual market, will not offer coverage in 2027.
• Small group plans. These end December 31, 2026.
• Large group and association plans. No new commercial plans in 2027, though some employer plans may continue into 2027. Those are the commercial patients you may still see.
• Oregon state employees. The Public Employees' Benefit Board will not offer Providence Health Plan medical plans in 2027. For a member who enrolls in a Moda Health plan, a Providence prior authorization transfers automatically and stays valid for the first 90 days of 2027, and PEBB names behavioral health care in the middle of therapy or medication management as an example that may qualify for transition of care.
• Self funded groups. Collective Health remains responsible for claims processing through each self funded group's claims run-out period. Check eligibility for Providence Health Plan Powered by Collective Health members in Availity, not ProvLink.

Verify eligibility before every service, as Providence's FAQ asks. Our insurance verification checklist covers what to ask.

What happens to Medicare Advantage and OHP patients on January 1, 2027?

Medicare Advantage. Members pick 2027 coverage during Medicare Annual Enrollment, October 15 through December 7. CMS enrollment guidance gives members of a plan non-renewed effective January 1 a special enrollment period from December 8 through the end of February, with coverage starting January 1, February 1 or March 1 depending on the month they enroll. Providence's FAQ says Original Medicare or the new plan takes over payment for other covered services on the termination date, so a former Providence patient can be on Original Medicare in January and in a new plan by February or March. Check Medicare eligibility at every visit through March. Health Share says its Providence members who also have Medicare will have their Medicare Advantage plan change to CareOregon Advantage Plus in 2027.

Inpatient stays across January 1. Under 42 CFR 422.318, when Medicare Advantage coverage ends during an inpatient stay, the plan stays responsible until discharge, and the rule names psychiatric hospitals among the facilities it covers. Providence's FAQ applies it to prospective payment system hospitals. Residential, partial hospitalization and outpatient care from January 1 belongs to the new coverage.

OHP. Health Share members in Providence Health Assurance medical plans move automatically to CareOregon on January 1, 2027 and keep their OHP coverage. Check who your behavioral health contract is with. Providence's provider networks page says behavioral health providers must contract directly with Health Share to serve these members, and its Health Share member page says CareOregon manages Health Share's mental health and substance use network. The notice ends the Health Plan OHP Network/PHA OHP Network; no source we opened says it changes an agreement held directly with Health Share or CareOregon. Our guide to contracting with Oregon CCOs covers those agreements.

How do claims for earlier dates of service get paid after the end dates?

• Medicare Advantage and OHP. Services before termination that are "timely billed during 2027" are paid as before. The notice does not define timely, and the FAQ says timely filing requirements remain unchanged at this time, so look to the limit in your agreement or provider manual. We treat the earlier of that limit and December 31, 2027 as the deadline.
• MCO Services Agreements. Earlier services timely billed during 2028 are paid as before.
• Commercial. There is no matching sentence. Claims payment terms survive for the period in your agreement, so get Providence's run-out answer in writing before 2028.
• Mechanics. As of the October 13 FAQ, claims addresses, payer IDs, support contacts and ProvLink are unchanged, and Providence says it will announce any change in advance.

Run-out is where payer exits lose money quietly, on the claims nobody rebills because the payer is leaving. Our revenue cycle collections guide shows where that leak surfaces, and our AR benchmarks by payer class show how to read the aging.

What survives after the contracts end?

• Audit and recoupment rights. Section VIII keeps the claims payment, overpayment recovery, audit rights, record retention, reconciliation, dispute resolution, confidentiality and fraud and abuse provisions in effect "for the period specified in the Agreement or as required by applicable law." The notice does not state those periods.
• Value based settlements. Section VI makes termination prospective only, so programs for earlier services run through measurement, reconciliation, audit, settlement and payment. Our value based care guide covers these arrangements.
• Retroactive eligibility. Employer groups ending December 31, 2026 have until January 31, 2027 to send final eligibility changes, and Providence's member claims page says a retroactive denial may lead it to ask the provider to refund the claim payment.

Section VII winds down the rest. Once Providence has no enrolled members assigned to you or eligible for your services in a terminated line, your reporting, quality, access, care management, data and credentialing duties for that line stop, ongoing fees end except amounts already accrued, and none of it returns without a new written agreement signed by both parties.

What should a program do before January 1, 2027?

• Pull every agreement. Participation agreements, amendments, fee schedules, MCO services and credentialing delegation all fall under the notice. Note each end date.
• Find what the notice leaves out. Your filing limit is in your agreement or provider manual, and the survival periods for audits, recoupment and records are in your agreement or set by law. Calendar them.
• Clear 2026 Providence AR early. Bill, work denials and file reconsiderations while contacts and processes are unchanged.
• Plan the authorization handoff. Providence honors existing authorizations, but each new plan sets its own, and PEBB's 90 day transfer to Moda is the only published handoff we found. Our concurrent review guide covers holding a stay through review.
• Contract the replacements. Check that you are in network with the plans your Providence patients choose, using our payer contracting guide. Providence stopped accepting new contracts that need full credentialing after October 1, 2026, though its behavioral health network page still listed open panels on October 22, 2026.
• Get settlement dates in writing. Ask your Provider Relations representative, or PHP customer service at 503-574-7500, when each 2026 value based program settles.

Frequently asked questions

When do Providence Health Plan provider contracts end?

Under the October 15, 2026 notice, Medicare Advantage and Oregon Health Plan participation ends January 1, 2027, with performance through December 31, 2026. Commercial participation, including the Behavioral Health Network, ends January 1, 2028. Commercial value based programs end January 1, 2027, except the Providence Choice Medical Home Exhibit, and MCO Services Agreements and credentialing delegation end January 1, 2028.

Will Providence pay 2026 claims we submit in 2027?

For Medicare Advantage and OHP, the notice says services provided before termination that are timely billed during 2027 will be processed and paid as before. It does not define timely. Providence's October 13 FAQ says timely filing requirements remain unchanged at this time, so for now the filing limit in your agreement or provider manual still applies.

Can Providence still audit or recoup payments after the contracts end?

Yes. The notice keeps provisions on claims payment, overpayment recovery, audit rights, record retention, reconciliation and dispute resolution in effect for the period in your agreement or as the law requires. It does not state those periods, so check your agreement.

What happens to Providence OHP members in Health Share of Oregon?

Providence Health Assurance members enrolled through Health Share move to CareOregon on January 1, 2027 and keep their OHP coverage. Providence says behavioral health providers contract directly with Health Share to serve these members, and that CareOregon manages Health Share's mental health and substance use network.

Is Providence still credentialing new behavioral health providers?

Not under new contracts. Providence's FAQ says new contracts requiring full credentialing will not be accepted after October 1, 2026. Groups with existing contracts can add practitioners case by case through their Provider Relations representative.

Close out Providence without leaving money on the table

A payer exit is a revenue cycle event before it is a contracting one. The money at risk is the 2026 claims still unbilled, the denials nobody appealed and the payments a later audit can take back. Our billing team has run treatment programs, so we read a Providence denial the way a clinical director and a biller read it together. Start with our free 90 day claims review: under a signed BAA we read 90 days of your claims, denials and aging AR and show you, in dollars, what is still collectible before filing limits close and which claims went to terminated coverage. Our behavioral health billing service then works the Providence run-out, while our revenue cycle and payer team lines up the contracts that replace it.