Practice Tactics
HRSN Rule Updates Now Effective
Recent updates to Oregon Administrative Rules are now in effect and include required changes for Health-Related Social Needs (HRSN) service providers. The revisions affect service delivery, billing and operational workflows.
Providers should review the full rule updates by searching for HRSN changes on the Oregon Secretary of State website.
Key updates include changes to clinical risk factors, eligibility criteria and utility assistance requirements.
Updated clinical risk factors for HRSN rent and utility services
Domestic violence experience replaces interpersonal violence experience and includes:
- Domestic violence within the past 365 days. Self-attestation is permitted when documentation would be unsafe.
- Child welfare involvement within the past 365 days related to domestic violence.
Revised complex health conditions criteria
- Conditions must be acute, worsening or unstable and may be physical, oral or behavioral.
- Members must have engaged with health care services within the past year related to worsening symptoms. This may include hospital, residential or outpatient care, including services provided by Traditional Health Workers.
Utility assistance clarifications
- Utility assistance is available only when HRSN rent assistance has been approved.
- Streaming services and entertainment-related devices are not covered.
Additional flexibility may apply when a utility bill does not match the rental address in situations where the address is not listed.
Prior Authorization Timeline Updates
Effective Jan. 1, updated turnaround timelines apply to standard medical and behavioral health prior authorization requests.
Standard prior authorization determinations will be completed within seven calendar days of receipt.
If additional clinical information is required, a one-time extension of up to 14 calendar days may be applied to complete the review.
These updates are intended to support timely care decisions while maintaining appropriate clinical review and reducing avoidable delays in care.
Duplicate Authorization Requests Policy
To reduce processing delays and support timely reviews, providers are reminded of the policy regarding duplicate submissions.
Requests for services that were denied within the past 60 days are considered duplicate submissions. Duplicate requests will be dismissed.
Members will be notified of their right to appeal the original determination and informed that support is available to assist them through the appeal process.
Providers should not resubmit prior authorization or service requests within 60 days of a denial. This applies even if new documentation is available or a different diagnosis code is submitted. Instead, providers should help members submit an appeal by following the appeal instructions available on the Umpqua Health Alliance website.
No Benefit Plan Changes
There are no benefit plan changes to report at this time.
Any future updates will be communicated as they become available.
THW Connections Corner
Traditional Health Workers Celebrate Year of Service
In December, Traditional Health Workers (THWs) from Douglas County gathered at Aviva Health to celebrate a year of impactful work.
THWs from multiple organizations came together for a potluck, bingo with prizes and music provided by DJ and peer support specialist Rob Gandy.
The group also organized a service project, assembling hygiene kits that were distributed at First Thursday in December. Special thanks to Dana Rice from UCAN for helping distribute the kits. Photos from the celebration and service project are included below.
Southern Oregon Nonprofit Summit Returns
The third annual Southern Oregon Nonprofit Summit will be held April 8–9 at Aviva Health.
This low-cost, low-barrier conference is designed to support rural nonprofit organizations across Southern Oregon by providing a practical space to connect, share ideas and build essential skills.
The summit emphasizes collaboration and innovation, equipping participants with tools to strengthen their organizations and expand their impact while addressing challenges unique to rural communities. Additional details, including registration information and session highlights, will be shared as they become available.
CME for Thee
New Oregon Language Access Workbook
Increasing Language Access in Oregon: A Workbook for Providers is a new resource designed to help health care organizations and providers understand Oregon’s language access requirements and take practical steps to ensure patients receive care they can understand.
The workbook outlines strategies to:
- Meet federal and state language access standards.
- Improve performance on the Meaningful Language Access (Health Equity) measure.
- Strengthen trust and communication with patients who prefer a language other than English or who use sign language.
The workbook was developed by NORC at the University of Chicago in collaboration with the Oregon Health Authority and was launched during a one-hour webinar held Dec. 9.
Slides and a recording of the webinar will be posted soon to the language access technical assistance webpage. Providers are encouraged to review the workbook and share it with teams involved in patient communication and care delivery.
THW Cervical Cancer Prevention Training
The OHSU Knight Cancer Institute is offering an online training for Traditional Health Workers focused on eliminating cervical cancer.
This live, two-hour course is led by the South Coast Community Cancer Control Specialist and offers two hours of continuing education credit.
Training topics include:
- Promoting cervical cancer prevention through HPV education, screening and vaccination.
- Understanding cervical cancer risk factors and available screening options.
- Supporting early detection and vaccine uptake in the community.
- Using effective communication strategies to engage communities and address concerns.
Training details
- Date: Tuesday, Jan. 13
- Time: 3–5 p.m.
- Format: Live online via Zoom
- Capacity: Limited to 30 participants
Register Now
Advance registration is required. Providers are encouraged to register early to secure a spot.
2026 Oregon Doula Conference
The 2026 Oregon Doula Conference will be held Monday, April 13, 2026, from 9 a.m. to 4 p.m. PDT at the Florence Event Center.
The conference brings together doulas, birth workers and partners from across Oregon for a full day of education, connection and professional development.
Register Now
Registration is now open.
Clinical Corner
Conversio Health Program Ending
Umpqua Health is sharing an upcoming update to the Conversio Health program that may affect some members.
Conversio Health is a chronic respiratory management program that provides support services, as well as nebulizer and inhaler medications, to enrolled members diagnosed with asthma or chronic obstructive pulmonary disease (COPD).
Effective Feb. 1, 2026, Conversio Health will no longer be contracted to provide services and will no longer participate in the Umpqua Health pharmacy network. Members currently enrolled in the program may continue to receive medications from Conversio Health through Jan. 31, 2026.
Who May Be Affected
This update may affect providers who care for members enrolled in the Conversio Health program, particularly those prescribing:
- Compounded medications
- Nebulized (liquid) medications
- Commercial inhalers
Providers without members enrolled in the program are not affected.
Provider Awareness and Next Steps
Umpqua Health has notified members and providers who may be impacted by this change. To support continuity of care, providers may be asked to:
- Review treatment plans for affected members.
- Discuss medication options and pharmacy transitions with members, as appropriate.
- Submit new prescriptions to an in-network retail or mail order pharmacy when needed.
For some members, this may include transitioning to an alternative medication. Certain inhalers may require prior authorization. Early submission is encouraged to help avoid disruptions in therapy.
Pharmacy Options for Members
Members may fill prescriptions at any in-network pharmacy or choose mail order services, which deliver medications directly to the home.
Mail order pharmacies
- Postal Prescription Services: 1-800-552-6694 | ppsrx.com
- BirdiRx: 1-855-247-3479 | birdirx.com
A full list of in-network pharmacies is available at:
providerdirectory.uhaweb.com/ClientApp/pharmacies
Additional Support
Umpqua Health Pharmacy Services and Customer Care are available to assist members and providers with pharmacy transitions, coverage questions and prior authorization needs.
Umpqua Health Pharmacy Services
Pharmacy and Therapeutics Update
The following formulary and prior authorization (PA) updates are being shared to support prescribing decisions and reduce disruptions in care.
Formulary Updates
| Medication | Update | Prior Authorization | Notes |
| Simpesse | Added | No PA required | Extended-cycle oral contraceptive containing levonorgestrel and ethinyl estradiol |
| Starjemza | Added | PA required | Stelara biosimilar; indicated for plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis (adults and select pediatric patients) |
| Benzoyl peroxide 5% cleanser and gel | Added | No PA required | For treatment of mild to moderate acne |
| Chlorhexidine gluconate 4% liquid (Hibiclens) | Added | No PA required | Broad-spectrum antiseptic liquid soap |
| Fiber 0.4 g capsules | Added | No PA required | Supports digestive health, constipation relief, cholesterol and blood sugar management |
| Nix 1% cream rinse (brand) | Added | No PA required | Permethrin-based OTC treatment for head lice and nits |
| J0878 (daptomycin) | Updated | No PA required (in network) | Antibiotic for serious bacterial infections |
| Nitro-Dur patches | Removed | N/A | Brand-only product with no member utilization |
| Steqeyma | Removed | N/A | Removed due to high cost and no utilization; other Stelara biosimilars remain available |
Prior Authorization Criteria Updates
| Drug or Class | PA Update Summary |
| VMAT2 inhibitors | Added Tourette syndrome indication; aligned trial-and-failure requirements with FFS; added renewal questions addressing clinical improvement |
| Clonazepam | Updated indications; trial-and-failure requirements aligned with FFS |
| CGRP antagonists | Trial-and-failure aligned with FFS; removed cardiac exclusions for chronic migraine; removed neurologist-only prescribing requirement; removed prophylactic requirements for beta-blockers, anticonvulsants and antidepressants |
| Diabetic diagnostics | Updated Type 1 diabetes criteria; removed insulin pump requirement for Type 2 diabetes; added glycogen storage disease type 1a; included updated sensor technologies |
| Sedatives | New PA criteria created; aligned with FFS requirements |
Clinical Practice Guidelines Updated
The Clinical Advisory Panel met in December and approved the addition of the Medications for Opioid Use Disorder Playbook to the Umpqua Health clinical practice guidelines (CPGs).
Developed by the Agency for Healthcare Research and Quality, the playbook is a comprehensive reference that supports evidence-based treatment of opioid use disorder, including the use of medications as part of a whole-person approach to care. The full list of Umpqua Health clinical practice guidelines, including links to all current CPGs, is available on the Umpqua Health website.
Community Announcements
Healthy Eating Support in January
As you talk with patients about food, diet, or blood sugar control, we want to share a free community resource that may support those conversations outside the exam room.
On Jan. 28, the Healthy Living Team will offer two free, in-person opportunities in Roseburg designed to build confidence around everyday food choices:
A hands-on cooking demonstration focused on simple, fiber-rich meal preparation strategies.
A guided grocery shopping tour to help patients navigate healthy options on a budget.
These opportunities may be especially helpful for patients managing prediabetes, working toward healthier eating habits or feeling unsure where to start.
Registration is required. Patients can call (541) 672-8533, option 2, to learn more or sign up.
Community Programs Support Diabetes Care
Conversations about blood sugar, nutrition and lifestyle changes are a routine part of care for many patients. In January, two community-based programs are available to help reinforce those discussions outside the exam room.
Beginning mid-January, Cow Creek and community partners are offering structured lifestyle and nutrition programs focused on preventing or managing chronic conditions, including diabetes. These programs provide practical skills, peer support and evidence-based guidance.
Diabetes Prevention Program
Starting Jan. 15 at noon, the Diabetes Prevention Program will be held at the Cow Creek Health and Wellness Center South Clinic.
This scientifically proven program is facilitated by Certified Lifestyle Coaches and focuses on preventing Type 2 diabetes through nutrition, physical activity and sustainable lifestyle strategies. Cooking demonstrations and recipe samples are included in each session.
For more information, patients can call (541) 672-8533 or email info-healthyliving@cowcreek-nsn.gov.
Lifestyle and Nutrition Course: Food as Medicine Oregon
Beginning Jan. 13, 2026, this course focuses on the role of food in preventing and managing chronic conditions such as diabetes, heart disease and obesity. The program emphasizes nutrition education and practical lifestyle approaches.
Patients can learn more by calling (521) 378-6359 or visiting FoodAsMedicineOregon.org.
These programs may be especially helpful for patients who are motivated to make changes and are seeking structured, ongoing support.
Community Walking Group Offers Ongoing Support
For patients who may not be ready for a structured program or who would benefit from low-barrier ways to increase physical activity, an ongoing community walking group is available through Cow Creek.
Movement Is Medicine: Cow Creek Health and Wellness Walking Group
The walking group meets every second and fourth Tuesday of the month from 9–10 a.m. at Millsite Park, near the covered bridge at the southeast end of the park. The group is open to all community members and does not require registration.
Participants can support their health through regular movement, connect with others in the community and enjoy time outdoors. Walks are led by a Registered Dietitian, offering an informal opportunity to discuss nutrition-related topics in a relaxed setting.
For more information, patients can contact Claire Grubb, RD, at (541) 672-8533, ext. 5266.
Sharing accessible options like this can help patients build healthy habits over time and feel supported beyond the clinical setting.
Network News
Umpqua Health Alliance Network Changes
Termed Providers
The following providers have been removed from the Umpqua Health Alliance network:
| Provider Name | Facility | Effective Date |
| Sandra Kolapo, NP | PeaceHealth | 11/30/2025 |
| Denise White, NP | PeaceHealth | 11/24/2025 |
| Jarrod Cullan, MD | Centennial Medical Group | 11/30/2025 |
| Amanda Manning PA-C | PeaceHealth | 12/19/2025 |
| John Brandon PA | Serenity Lane | 12/19/2025 |
| Doug Gomez PHD | Serenity Lane | 12/19/2025 |
| Cheryl Gifford PHD | Serenity Lane | 12/19/2025 |
| Nancy Burgess NP | Serenity Lane | 12/19/2025 |
| Denies Marsh CADC-I | Serentiy Lane | 12/19/2025 |
| Cherie Thomas CADC-I | Serenity Lane | 12/19/2025 |
| Kimberly Schafer CADC-II | Serenity Lane | 12/19/2025 |
| Jennifer Katuska CADC-I | Serenity Lane | 12/19/2025 |
| Katherine Johnson CADC-I | Serenity Lane | 12/19/2025 |
| Brian Senchina CADC-R | Serenity Lane | 12/19/2025 |
| Christina Natali CADC-I | Serenity Lane | 12/19/2025 |
| Jace Decker CADC-I | Serenity Lane | 12/19/2025 |
| Preti Satyanarayana MD | CEP America | 12/19/2025 |
| Jacque Verbeck THW | Rogue Valley Doulas | 10/4/2025 |
| Matthew Sbardella | Boulder Care | 5/15/2025 |
| Jonathan Schwartz | OSLC | 9/30/2024 |
| Lawrence Brown | OSLC | 8/31/2023 |
| Kathryn Anderson, PHARM | PeaceHealth | 11/26/2025 |
| Dianna Gibson, CRNA | PeaceHealth | 06/06/2025 |
| Aaron Hougham, MD | PeaceHealth | 12/15/2025 |
| Erin Johnson, LPC | PeaceHealth | 11/27/2025 |
| Winona Yellowhammer, QMHP | Adapt | 12/31/2025 |
| Nicholas Jorgensen, PHARM | PeaceHealth | 12/08/2025 |
| Alyssa Davidson, LCSW | Juniper Tree | 12/31/2025 |
New Providers
The following providers have joined the Umpqua Health Alliance network:
| Provider Name | Facility | Effective Date |
| Malinda Whitfied, NP | PeaceHealth | 11/24/2025 |
| Destiny Gmelch, MD | PeaceHealth | 12/02/2025 |
| Stacey Stockton, NP | PeaceHealth | 12/02/2025 |
| Stephanie Huynh, LCSW | PeaceHealth | 12/22/2025 |
| Jennifer Webster, MD | PeaceHealth | 12/16/2025 |
| Charisse Williams-Stewart, NP | PeaceHealth | 12/08/2025 |
On the Lookout
No announcements this month.
Dental Digest
Motivational Interviewing to Improve Patient Communication
Motivational interviewing is a patient-centered communication approach that helps dental providers build trust, explore readiness for change and encourage healthier oral care behaviors. By emphasizing empathy, active listening and patient-led dialogue, this approach can improve treatment acceptance, patient satisfaction and long-term outcomes.