Practice Tactics
Physical Therapy Code Group Addition
For your convenience, Umpqua Health Alliance (UHA) has grouped CPT codes 97161, 97162, 97163, and 97164 into a single Procedure Code Group.
This enhancement allows providers to:
- Submit one code from the group
- Enter the total number of requested visits
- Retain full flexibility to bill the appropriate evaluation or re-evaluation code at the time of claim submission
Example:
If you are requesting:
- 97161 × 1 visit
- 97162 × 1 visit
You may:
- Enter one of the codes
- Select “Code Group – PT Evaluations” from the dropdown menu
- Indicate the maximum total number of visits requested (2 visits)
This authorization will approve all codes within the group for the requested quantity, allowing you to bill any of the included CPT codes as clinically appropriate for each visit.
Durable Medical Equipment Updates
A new auth referral type has been added to CIM, “Durable Medical Supplies – Repairs”.
DME vendors submitting requests for repairs of medical equipment on the CIM provider portal should use this auth referral type. This includes repairs of complex rehabilitation technology such as manual or power wheelchairs, adaptive seating systems, alternative positioning systems, adaptive strollers, standing frames, gait trainers, or specifically designated options or accessories.
OHA criteria require that these are processed within 72 hours of submission, so please select “Expedite” for the urgency when submitting these requests. Extensions to the timeline cannot be made for missing information on these requests. Please be sure that requests submitted have complete documentation to avoid denial of requests.
Benefit Plan Updates March and April 2026
Added as Excluded Services Guideline E1:
98976, 98977, 98984, 98985, 98986, 99445, G0322, G0327, 80050, 87482, 87487, 87492, 87512, 87530, 87542, 87592, 87652, 87798, 87799, 87149, 86328, 86143, 86769, 87797, 87150, 87623, 87640, 87507, 0115U, 0202U, 97014, 97035, 52443, 55877, 94669, 99174, 99177,
Added as Excluded Services Guideline E2:
81525, 87153, 37262, 37279, 0583T, 86727, G0561, 55875, 20552, 20553
Added to Procedures Tab as PA required-Any provider:
55868, 55869, 55707, 55708, 55709, 55710, 55711, 55712, 55713, 55714
Changed From Excluded Services to PA required-Any provider:
64566, 15777, 47383, 91120, 93890, 93893, 27418, 62380, 81287, 15773, 15774, 15820, 15821, 29866, 29867, 31627, 31647, 31648, 31649, 31651, 43842, 43843, 43845, 43886, 43887, 43888, 53854, 58674, 66174, 66175, 93892, 81301, 81306, 81335, 81425 (PLHS attribute: D1), 81426 (PLHS attribute: D1), 81427 (PLHS attribute: D1), 81518 (PLHS attribute: 148), 81542, 83631, 84590, 84591, 84597
HRSN Nutrition Updates
Added as Excluded Services Guideline E1:
Medically Tailored Meals (MTMs) are nutritious, home-delivered meals customized by registered dietitians for patients with severe chronic illnesses (e.g., diabetes, heart failure, COPD, kidney or liver disease) or high-risk pregnancies. Qualifying members can receive up to 6 months of meals delivered directly to their home.
Specific qualifications can be found in the OHP HRSN medically tailored meals clinical eligibility guide.
Providers who would like to support members in accessing this service may refer members directly to a registered dietitian nutritionist (RDN) for the development of a nutrition care plan. Alternatively, members can submit an application, and UHA will help eligible members access RDN services.
Fruit & Vegetable and Pantry Stocking
The Oregon Health Authority (OHA) has delayed the start of the Fruit & Vegetable and Pantry Stocking benefit to July 1, 2026.
UHA is actively preparing for the launch of this new benefit. Similar to other Health-Related Social Needs (HRSN) services, members will need to meet specific eligibility criteria to qualify. These criteria will include alignment with a defined population, as well as certain clinical and social risk factors.
Additional details regarding eligibility and qualifying member populations will be shared as OHA releases further guidance.
CIM Portal Access
Reminder that contracted providers are required to use CIM portal.
Non-contracted providers are also encouraged to use it. Using the CIM provider portal makes it easy to track the progress of your prior authorization requests as they move through the process. Providers can upload documentation and communicate directly through the request. Please use the link below to access instructions on signing up for CIM portal access.
Requests to Amend an Authorization
In-network providers must submit amendment requests in the CIM portal. Amendments can only be made by the provider that submitted the request. Please follow the steps below to submit your amendment:
- Locate the prior authorization you wish to change by searching the reference number of the PA or by locating the PA in the member’s Care Type History.
- Once the authorization loads select the drop down arrow for “Referral”.
- Select “Extend Authorization”.
- Follow the prompts on the screen changing / updating the information you would like.
- Add a short clarifying comment explaining the amendment request in the Comments text box.
If you do not have the extend option in the referral drop down:
- Copy or re-submit the authorization as a new request. Add a short clarifying comment explaining the amendment request in the Comments text box.
- Once the request is received, we can then link the original authorization to the new request and begin processing the amendment. This policy is to ensure proper recording and processing of authorization submissions and changes.
Out-of-Network Providers can submit requests by following the steps above, or by submitting a fax that clearly states an amendment is being requested and specifying the PA number to be amended.
THW Connections Corner
Oregon Rural Health Transformation Program Funding
Through May 26, eligible organizations can propose their innovative projects for a competitive Oregon Rural Health Transformation Program funding pool known as the Catalyst Awards. OHA expects to grant a total of about $80 million per year for up to two years, pending federal approval, toward Catalyst Award-supported projects. Up to 80 proposals will be funded by early July through this opportunity. Catalyst Awards will be given to projects that are ready to launch within two months of receiving funding and address at least one of the following areas: maternal and child health; co-occurring behavioral health conditions; aging in place; and chronic disease. More information about the application process is on the OHA Rural Health Transformation Program webpage.
To see projects already awarded as well as upcoming funding opportunities, visit the Rural Health Transformation Program (RHTP) webpage.
To sign up for the RHTP newsletter, click this LINK.
2026 Forum on Rural Population Health
The 2026 Forum on Rural Population Health is just around the corner—and this year’s agenda includes a strong focus on the people at the heart of rural health: community health workers (CHWs) and traditional health workers (THWs).
Sessions will highlight how CHWs and THWs are strengthening care, expanding access and driving meaningful change in rural communities across Oregon.
Date: May 14–15, 2026
Location: Virtual
CHW and THW Spotlight Sessions
This year’s Forum features sessions that explore:
- Innovative CHW training models. Learn how a virtual, age-friendly curriculum is equipping CHWs with tools to better support older adults
- Building rural training infrastructure. Explore how communities are developing locally responsive THW training hubs to grow and sustain the workforce
- Workforce development as a strategy for population health. Hear directly from rural practitioners, educators and leaders about what’s working—and what’s needed next
- Expanding care through community-based roles. Discover how CHWs are integrated into care teams, from primary care to EMS and community-based settings
Forum sessions highlight practical, real-world approaches that can be adapted across rural communities.
The Forum brings together partners from across Oregon to share ideas, strengthen connections and learn from one another in a collaborative, action-oriented space.Register Today!
Scholarships are available to help reduce cost barriers.
Apply for a scholarship
Grant Funded Certification Training for Rural CHWs
Applications ongoing | More information
ORH is offering scholarships for 24 community health worker (CHW) certification trainings through NEON’s virtual training program! This is a $1,500 value and comes with no cost to your organization. The next training cohort begins June 2, 2026.
To be eligible, CHW trainees must be employed at a hospital, clinic or local public health department, EMS agency or community-based organization in rural Oregon, based on rural as defined by the Federal Office of Rural Health Policy (FORHP), which can be confirmed using the Am I Rural? tool. Eligible organizations can fill out this form to apply.
Email Stepha Dragoon with any questions.
Oregon Community Health Worker Conference
Early bird registration is now open for ORCHWA’s 13th Annual Conference! Join CHWs and CHW allies from across Oregon to connect, learn, and celebrate. The conference will take place this year from August 27 – 28, 2026 in Salem, Oregon. Register now and save $50!
Please direct questions about ORCHWA’s annual conference to conference@orchwa.org.
Southern Oregon Workforce Investment Board Community Survey
The Southern Oregon Workforce Investment Board is working on next steps to support and strengthen the Traditional Health Worker (THW) workforce in our region and is beginning to pull together an application for upcoming opportunities with the Oregon Health Authority. This survey will help guide that work.
Partners, employers, current and future workers, and community members are invited to participate. Whether you’re interested in partnering, offering training, supporting this work, or just sharing your perspective, your input matters.
Use the link below or share the flyer:
CME for Thee
Bridging Specialties®: Timely Diagnosis and Treatment for COPD
Research shows that the opportunity to diagnose COPD at an earlier stage is missed in about two-thirds of patients with COPD. That’s a problem, since delayed diagnosis is linked to a higher rate of exacerbations, more comorbidities, and increased costs compared with an early diagnosis.
The goal of this activity is to educate clinicians on the symptoms and presentation of COPD to administer the appropriate diagnostic tests, determine the severity of disease, and proceed with the next steps in treatment and management of COPD. The toolkit offers educational resources such as an early detection module, a decision-making tool, an interactive infographic, podcasts, and downloadable clinical tools.
Content note: The FDA has recently approved dupilumab as an add-on maintenance treatment for adult patients with inadequately controlled COPD with type 2 inflammation.
Learning Objectives
- Discuss new and emerging research in diagnostic testing for COPD, including phenotype, endotype, and stage.
- Outline options for new and emerging treatments in the COPD space and how they will impact patient care.
- Describe the defining symptoms and patient profiles associated with COPD.
- Identify the diagnostic tests that validate a suspicion of COPD and its possible stage.
- Determine when/if it is appropriate to refer to a pulmonologist.
Youth Mental Health First Aid Training
Date: May 29, 2026
Time: 8:30 a.m – 4:30 p.m.
Location: Douglas ESD / Roseburg Public Library
Over half of young people with unmet mental health needs think no one would care if they got better. You can show them that recovery is possible with our trusted, evidence-based training.
How Youth Mental Health First Aid Helps
- Help Young People Grow and Succeed
- Understand Their Struggles
- Break the Stigma
- Know How to Get Them Talking
- Show Up With a Plan
- Help Youth Get the Care They Need
Youth SAVE (Suicide Assessment in Various Environments) Training
Youth SAVE (Suicide Assessment in Various Environments) is a virtual training designed to empower service providers in schools and community-based settings to effectively assess, screen, and intervene with children, youth, and young adults who are experiencing thoughts of suicide. Youth SAVE is a program of REAP, and is open to anyone in the US who works with young people.
Learn more about Youth SAVE.
Clinical Corner
Mail Order Pharmacy Program
UHA offers mail order pharmacy services through Postal Prescription Services as an included member benefit. Eligible members can receive maintenance medications delivered to their home with 90-day supply and refill support options, helping improve adherence and reduce pharmacy access barriers. Providers are encouraged to identify appropriate patients can utilize mail order when prescribing long-term medications.
Community Announcements
Ongoing and Recurring Wellness Activities
Community programs offer a practical way to bridge clinical guidance with daily routines. The ongoing activities described here are free, locally available and designed for consistent participation. These options can be aligned with care plans when community-based support is appropriate.
Mindful Movement Yoga
- When: Wednesdays, noon–1 p.m.
- Where: The Vortex Center, 865 SE Court Ave., Roseburg
Ongoing yoga sessions focused on mobility, breathwork and stress reduction. Suitable for all levels. No registration required.
Restorative Yoga: A Monthly Rest Ritual
- When: Second Saturday of each month, 4–5:15 p.m.
- Where: The Vortex Center, 865 SE Court Ave., Roseburg
Monthly restorative yoga session focused on relaxation and stress reduction.
Community Well-Being Challenge
A free, community-wide program encouraging healthy habits through events and activities throughout the year. Participants can join at any time and complete activities to qualify for end-of-year prizes.
Eagles Park Pop-Up Series
- When: Third Saturday of each month (April–October), 12–2 p.m.
- Where: 782 SE Jackson St., Roseburg
Monthly community event featuring art activities and games for all ages.
Several upcoming Douglas County programs support maternal mental health, heart health and diabetes prevention. Providers may wish to share these opportunities with patients and families.
Pride in Numbers Survey
Pride in Numbers has launched a statewide survey to uplift the lived experiences of Two-Spirit and LGBTQIA+ people across Oregon.
From healthcare to housing, safety to belonging, Pride in Numbers is creating a powerful portrait of Two-Spirit and LGBTQIA+ life in Oregon. The data and stories we gather will be shared back with the community, so our advocates, community organizations, and organizers – each of us – can build the programs, services, mutual aid networks, and policies we deserve and dream of.
Who can take the survey
This confidential survey is open to all Two-Spirit and LGBTQIA+ adults (18+) in Oregon, including those who are closeted.
NAMI Walks
NAMI Walks
Date: May 16 | 9 AM
Where: Courtyard between the Douglas County Courthouse & Justice Building – Roseburg
Learn more at NAMIWalks.org/Douglas
Network News
Network Changes
Termed Providers
The following providers have been removed from the Umpqua Health Alliance network:
| Provider Name | Effective Date | Facility |
| Natalie Jones, FNP | 04/03/26 | Aviva Health |
| Libby Sparks, PSS | 04/02/26 | Cow Creek Health and Wellness |
| Mollie Baker, LCSW | 03/27/26 | Stronger Oregon |
| Joshua Dahlenburg, LPC | 08/15/24 | Valley Drugs, Inc. |
| Jason Bernal, QMHA-R | 11/06/25 | Oregon Outreach Clinic |
| Laura Christensen, RD | 02/20/26 | PeaceHealth Cottage Grove |
| Lan Gao, DDS | 01/08/26 | Advantage Dental Reedsport |
| Nicole Lucas, APRN | 04/15/26 | Willamette Family |
| Jaime Lynn Hansen, FNP | 04/17/26 | Adapt – Roseburg |
| Jeffry Jacobs, MD | 11/26/25 | Oregon Community Programs |
| Jocelyn Sifuentes, QMHP | 04/22/26 | Adapt |
| Bonnie Jo Lamont, QMHP | 04/22/26 | Adapt |
| Michael Theisen, MD | 04/13/26 | CEP America |
| Rensie Chiara De Vera, MD | 04/15/26 | PeaceHealth – Cottage Grove |
| Natascha Allen-Halvorson, LPC | 10/13/25 | Cow Creek Health and Wellness |
| Rachel Ochoa, RN | 04/16/26 | Adapt – Brookings |
| Donna Buick, PSS | 04/16/26 | Adapt – Brookings |
| Cynthia Smith, QMHA | 04/16/26 | Adapt – Brookings |
| Deann Shaw, QMHA | 04/16/26 | Adapt – Brookings |
| Garrett Tovey, PSS | 04/16/26 | Adapt – Brookings |
| Heather Coates, CADC | 04/16/26 | Adapt – Brookings |
| Karin Donnelly, QMHP | 04/16/26 | Adapt – Brookings |
| Kiana Hendrix, QMHA | 04/16/26 | Adapt – Brookings |
| Amber gray, LPC | 04/16/26 | Adapt – Brookings |
| Carlos Lira, QMHA | 04/16/26 | Adapt – Brookings |
| Katie Hobbs, LCSW | 04/16/26 | Adapt – Brookings |
| Heidi Platt, QMHP | 04/16/26 | Adapt – Brookings |
| Krystal Van Pelt, QMHA | 04/16/26 | Adapt – Brookings |
| Amy Sale, PCA | 04/16/26 | Adapt – Brookings |
| Ashley Benson, CRM | 04/16/26 | Adapt – Brookings |
| Mersadies Castleberry, PSS | 04/16/26 | Adapt – Brookings |
| David Duffy, LMFT | 04/16/26 | Adapt – Brookings |
| Devin Azevedo, QMHA | 04/16/26 | Adapt – Brookings |
| Caitlin Vance, CRM | 04/16/26 | Adapt – Brookings |
| Katrina West, PCA | 04/16/26 | Adapt – Brookings |
| Jennifer Eichlin, QMHP | 04/16/26 | Adapt – Brookings |
| Ashleigh Strain, QMHA | 04/16/26 | Adapt – Brookings |
| Gina McDonald, QMHA | 04/16/26 | Adapt – Gold Beach |
| Lacy Premo, QMHA | 04/16/26 | Adapt – Gold Beach |
| Jasmine Carmack, QMHP | 04/16/26 | Adapt – Gold Beach |
| Eliza Janauskas, QMHP | 04/16/26 | Adapt – Gold beach |
| Garrett Shannon, QMHA | 04/16/26 | Adapt – Gold Beach |
| Cheyene Alexander, QMHA | 04/16/26 | Adapt – Gold Beach |
| Margaret Hall, QMHA | 04/16/26 | Adapt – Gold Beach |
| Kimberly Gilbert, QMHP | 04/28/26 | Adapt – Roseburg |
| Alexander Willoughby, MD, BS | 01/05/26 | Centennial Umpqua Valley Eye Associates |
| Emily Armstrong, MD | 01/06/26 | Centennial Umpqua Valley Eye Associates |
New Providers
The following providers have joined the Umpqua Health Alliance network:
| Provider Name | Effective Date | Facility |
| Danita Tracy-Carter, THW | 04/06/26 | Danita The Doula |
| Breyer Barkman, LCSW | 04/06/26 | Joyful Living |
| Christopher Bock, DC | 04/06/26 | Tri-City Walk In Chiropractic |
| Larissa Sutphen, APRN | 04/06/26 | Charlie Health |
| Jeffrey Wensel, MD | 04/06/26 | Virtual Radiologic Professionals |
| Jeremey Russell, QMHP | 04/06/26 | Willamette Family Treatment |
| Rhea Bandelier, PMHNP | 04/06/26 | Second Wind Mental Health |
| Jessica Hunnel, CADC | 04/06/26 | Affect Therapeutics |
| Minah Clark, LCSW | 04/06/26 | LGBTQ Telepsychiatry |
| Emily Karch, CSWA | 04/06/26 | Willamette Family Treatment |
| Willine Louis, APRN | 04/06/26 | Charlie Health |
| William Patterson, PWS | 03/31/26 | Adapt |
| Olivia Reid, CHW | 06/09/25 | Adapt |
| Jennifer Rilea, CADC | 03/10/26 | Adapt |
| Jessica Stout, QMHA | 03/04/26 | Adapt |
| Cale Wedell, CRM | 03/31/26 | Adapt |
| Laura Dunn, QMHP | 03/02/26 | Oregon Outreach Clinic |
| Peter Weber, MD | 09/17/25 | Oregon Eye Clinic |
| John Kennedy, MD | 11/25/25 | PeaceHealth Florence |
| Jennifer Mitchell, PHARM | 04/06/26 | PeaceHealth Florence |
| Jennifer Frost, FNP | 04/14/26 | Creekside Health & Wellness |
| Kiara Mixon, LPCA | 04/16/26 | Options Counseling Services |
| Holy Simons, CSWA | 04/16/26 | Joyful Living Behavioral Health |
| Daniela Smith, LCSW | 04/16/26 | Aviva Health Roseburg |
| Wendy Zyzniewski, FNP | 04/16/26 | Aviva Health Roseburg |
| Christine Lamoureux, MD | 04/16/26 | Virtual Radiologic Professionals |
| Victor Perez Labiosa, MD | 04/16/26 | Virtual Radiologic Professionals |
| Comfort Orebayo, OD | 04/09/26 | CEP America |
| Steffan Anderson, MD | 04/10/26 | PeaceHealth – Florence |
Upcoming Learning Opportunities for Clinical & Community Partners
We’re excited to offer two upcoming sessions designed to support your work in advancing equitable, high-quality care across our community.
Thursday, June 4 | 12:00 – 1:00 PM
Location: Teams
This collaborative session is designed for individuals involved in social needs screening and referral workflows. We strongly encourage organizations to send a team, as participating together helps build shared understanding, strengthens workflows, and improves implementation success.
Join us to:
- Collaborate with clinical and community partners
- Identify barriers and opportunities in SDoH screening and referrals
- Share best practices and actionable solutions
Language Access Webinar: Reporting & Services
Wednesday, June 10 | 12:00 – 1:00 PM
Location: Teams
This live webinar will cover key updates and resources related to language access. Whether you’re new to reporting or need a refresher, this session will provide practical guidance to support compliance and improve patient experience.
Topics include:
- Language access reporting refresher
- Key updates from 2025 to 2026 impacting reporting requirements
- Overview of interpreter services and resources available to your clinic and patients
Contact us at UHQualityImprovement@umquahealth.com to be added to the calendar invite. We look forward to your participation!
Resource for Members: Know Before You Go Flyer
Please share the attached “Know Before You Go” flyer with members to help reinforce appropriate use of primary care, urgent care, and emergency room services. This resource is designed to support members in making informed care decisions and understanding where to seek care based on the severity of their symptoms.
On the Lookout
Hepatitis C Treatment in Douglas County
Hepatitis C treatment used to be expensive, lengthy, poorly tolerated, and had low cure rates. Today, most patients can be cured in 8-12 weeks with minimal side effects, and treatment has been covered by Oregon Medicaid since January 2023. Thanks to testing, treatment and prevention activities like syringe exchange, rates of new hepatitis C infections are decreasing in Oregon. However, many people are still living in Douglas County with untreated chronic hepatitis C.
Douglas Public Health Network began a county-wide data review on hepatitis C treatment in July 2025 to identify inequities and barriers to treatment, and to inform public health outreach to prevent new infections and morbidity and mortality from hepatitis C. DPHN aims to provide support to providers developing treatment plans or referral options and to provide education and support to patients to address barriers. We looked at the treatment rates for patients newly diagnosed with hepatitis C between 2020 and 2023. Despite the burden of the Covid19 pandemic on our health care system, we were encouraged to find that almost half of all patients newly diagnosed in that time frame have been cured of hepatitis C.
Source: Douglas Public Health Network 2026
While more men (62%) were diagnosed with hepatitis C, the treatment and cure rates for both men and women were about the same. Patients living in small towns (less than 1,000 people) were less likely to be treated (36% cure rate vs 50%). Due to small sample sizes and insufficient data, we were unable to compare treatment rates by other demographic factors like race, ethnicity, insurance type or language. Patients in the age group 61 to 70 were the most likely to be treated, while those older than 71 years of age and younger than 30 were the least likely to be treated.
Treating Hepatitis C to Prevent Liver Cancer
Chronic hepatitis C can cause persistent inflammation which can lead to cirrhosis and liver cancer. About a fourth of people infected with HCV will develop cirrhosis 20-30 years later, and a fourth of persons with cirrhosis will develop end-stage liver disease or liver cancer resulting in death. About 500 Oregonians die every year from chronic hepatitis C. Oregon has the fourth highest prevalence and the third highest HCV mortality in the United States. Our southwest region had the highest rate of hepatitis-related liver cancers in Oregon from 2016-2021.
Resources on Integrating Hepatitis C Treatment into Primary Care:
- OHSU Provider Consult Line: 503-494-4567 Open daily 7am to 7pm
- Douglas Public Health Network: Andree Shidlovsky, 541-580-6832, Resources and case history, andree@douglaspublichealthnetwork.org
- Empire Liver Foundation: Provider training and education https://empireliverfoundation.org/hepatitis-provider-training/
- ECHO Connect, Treatment and Elimination: Community of practice with subject matter experts https://www.oregonechonetwork.org
- Aviva Health Nurse-Led Hepatitis C Treatment Management Program: Jess Freeman
- jfreeman@umpquachc.org, (541) 672-9596, ext. 258
- OHSU Paths Program: Peer Recovery Support Specialists at Adapt and HIV Alliance are available to assist people who use drugs to access hepatitis C and syphilis testing, telemedicine HCV treatment through OHSU, and support patients with medication adherence https://peerpathstohealth.org/
Dental Digest
Teeth Whitening: Is it for Me and What are My Options?
Selecting a product really depends on the degree of whitening you are looking for and the state your teeth are in – rather than pointing to a specific brand, make your decision based on what will work best given your current oral health.
Before designing a teeth whitening plan, it is recommended that you visit a dentist to examine, clean and repair your teeth to maintain healthy teeth and gums. Your dentist then has the opportunity to ensure you are not at increased risk for sensitivity or root damage. Also, brushing at least twice daily and flossing every day can help remove stains that darken your teeth.
Social Determinants of Health (SDoH) Clinical & Community Partner Collaborative