Umpqua Health Alliance corporate policy (CE19) defining covered substance use disorder services and requirements, including criteria for treatment authorization, levels of care, and coordination with behavioral health providers.

Umpqua Health Alliance corporate policy (CE12) outlining prior authorization requirements, processes, and timelines for medical, behavioral health, and pharmacy services, including provider submission requirements and member notification procedures.

Umpqua Health Alliance corporate policy (CE11) defining covered services under the Oregon Health Plan, including the scope of benefits, exclusions, and procedures for determining coverage for physical health, behavioral health, and dental services.

Umpqua Health Alliance corporate policy (CE05) establishing procedures for utilization review, including criteria for reviewing service requests, decision timelines, and member and provider notification requirements.

Umpqua Health Alliance corporate policy (CE03, Version 8) establishing a framework for Wraparound care services for youth members and their families, tailored to individual needs in compliance with OAR 309-019-0162 and OAR 309-019-0163 and aligned with the CCO Contract with OHA.

Umpqua Health Alliance corporate policy (CE01, Version 19) establishing internal grievance and appeal procedures under which members, authorized representatives, or providers may file complaints or appeal adverse benefit determinations, in compliance with OAR 410-141-3835 through 410-141-3915 and 42 CFR § 438.400 through 438.424.

Resource list compiled from the National Institute of Corrections’ 2020 Becoming Trauma-Informed Webinar Series, including videos, readings, and tools to support trauma-informed practices in behavioral health and community care settings.

Reference chart of Umpqua Health Alliance’s 2025 focus measures for Oregon Health Plan quality improvement, including adolescent and childhood immunizations, SUD treatment engagement, language access, and diabetes HbA1c poor control.

Historical reference chart tracking Oregon CCO incentive measures from 2013 through 2025, showing which quality metrics were active each year and how the quality improvement framework has evolved for Umpqua Health Alliance.

Training resource for providers and staff on collaborative social needs screening and referral processes, covering required training modules in cultural responsiveness, equitable practices, and social determinants of health screening for OHP members.

Training materials for Oregon’s First Tooth initiative, integrating oral health into primary care settings to reduce early childhood cavities by training medical providers to deliver preventive dental interventions.