Provider Digest | Volume 193

Date: 11/05/25

Winter 2026 Echo Programs

• Registration is now open for Oregon ECHO Network programs that start in January. Below you will find information and registration links for ECHO programs, and communities of practice. 

• We are excited to be offering new ECHO programs this term on Alzheimer's care, autism and ADHD in adults, and screening for social needs. 

• Continuing education credits are available and each program is offered at no cost to you or your workplace. 

• ECHO programs fill quickly. Please visit our website at OregonECHONetwork.org as soon as possible if you are interested in participating in any of these programs.
  

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Update for Wellcare Medicare Advantage Providers:
Telehealth Covered Services

Medicare telehealth flexibilities expired on March 31, 2025 and Original Medicare telehealth flexibilities reverted to pre-pandemic Medicare requirements on September 30, 2025.

However, Wellcare By Health Net and Wellcare By Trillium Advantage Medicare Advantage plans have benefits set to match the flexibilities that have been in place as additional benefits. This means that even with the end of Medicare flexibilities, Wellcare Medicare members continue to have access to certain covered benefits for telehealth services. This applies to both the 2025 and 2026 plan years.

Wellcare plans offer telehealth services without limitations of geography and location. Benefits include:

• Members do not need to be in a rural area to receive telehealth services.
• Members do not need to be at an originating site to get telehealth.
  • Instead, they can get telehealth wherever they are located.
    
• Members can use their provider or Teladoc.
  • Telehealth is available through our vendor, Teladoc, 24 hours a day, 7 days a week at $0 cost share.
  • Telehealth services from in-network providers will apply the cost share related to that provider. For example, Telehealth from a PCP will apply PCP cost share; Telehealth from a specialist will apply specialist cost share. Members should refer to their EOC for full listing of applicable cost shares.
• There is not a technological requirement as a part of the Telehealth benefit. Audio-only telehealth for some non-behavior or non-mental telehealth is permitted.

If you have any questions, please contact your assigned health plan Provider Engagement Administrator:

• Wellcare By Trillium Advantage Regional Rep Contacts
• Wellcare By Health Net Regional Rep Contactss.

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Health Net Oregon Clinical Policies Update

Effective December 1, 2025, Health Net of Oregon will be retiring the following Commercial clinical policies. You can find all active Commercial clinical policies on our Policies and Criteria webpage. (Note: After December 1, the below policies will no longer be posted on our website.)

Policy Retiring on December 1, 2025:

• Policy Name: CP.MP.167
• Policy Title: Intradiscal Steroid Injections for Pain Management
• Justification: The associated CPT Code is not on the current Pre-authorization list.

Thank you for your partnership in helping our members stay healthy. If you have any questions, please contact your Provider Engagement Representative.

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Trillium Medicaid Clinical Policies Update

Effective December 1, 2025, Trillium Community Health Plan will be retiring the following Medicaid clinical policies. You can find all active Medicaid clinical policies on our Policies & Criteria webpage. (Note: After December 1, the below policies will no longer be posted on our website.)

Policy Retiring on December 1, 2025:

• Policy Name: CP.MP.133
• Policy Title: Posterior Tibial Nerve Stimulation for Voiding Dysfunction
• Justification: OHA Guideline POSTERIOR TIBIAL NERVE STIMULATION being applied.

Thank you for your partnership in helping our members stay healthy. If you have any questions, please contact your Provider Engagement Representative.

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Reminder: New Provider Engagement Email Box for Trillium, Health Net and Wellcare Providers

Effective September 15, 2025, we consolidated our Provider Engagement email addresses to a single email address that can be used by all of our Trillium, Health Net and Wellcare providers. For more details, review the original article below. And please add the new ORProviderExperience@TrilliumCHP.com email box to your contact list and remove the old email boxes that are set to decommission on October 15, 2025. Thank you!

New Provider Engagement Email Box for Trillium, Health Net and Wellcare Providers
Starting September 15, it will be even easier to interact with our health plans! To streamline your experience, you will be able to reach your Trillium, Health Net and Wellcare Provider Engagement Team through the same email address!

What is changing on September 15, 2025?

• New Trillium, Health Net and Wellcare Provider Engagement email box: Trillium, Health Net and Wellcare providers can reach us through one Provider Engagement team email box: ORProviderExperience@TrilliumCHP.com. Save this email address in your contacts and use it to access support from our Provider Engagement team for any of our lines of business for which you are contracted. 
• Trillium, Health Net and Wellcare  providers will also use the Provider Engagement team email box for Credentialing and Provider Rosters: Starting September 15, send your provider credentialing, rosters and roster updates to ORProviderExperience@TrilliumCHP.com. Your dedicated Provider Engagement Administrator will review your documents upon receipt to ensure accuracy of your requested updates before sending for processing. 
• New email box for non-participating providers: We now have a dedicated email box to assist non-participating providers who serve our insured Trillium, Health Net and Wellcare members: ORNonParSupport@TrilliumCHP.com
• Mail sent to old email boxes will be forwarded until October 15: To give you some time to transition to our new email boxes, any messages you send to the previous email boxes, including hnor_provideroperations@healthnet.com and tch_provideroperations@centene.com, will be forwarded to the new Provider Engagement team email box until October 15, 2025. Add our new centralized Provider Engagement team email box, ORProviderExperience@TrilliumCHP.com, to your contacts and start using it on September 15. It’s an easy way to reach your Provider Engagement team for all our lines of business!

What is staying the same?

• Connecting with your dedicated Provider Engagement Administrator: We value our contracted provider partners and have assigned a dedicated Provider Engagement Administrator (PEA) to assist you. You can continue to reach out to your PEA as you do today for support. If you do not recall the name of your PEA, please visit the Regional Rep Contact tab on our websites:
  • Trillium and Wellcare By Trillium Advantage Regional Rep Contacts
  • Health Net and Wellcare By Health Net Regional Rep Contacts

Thank you for being a valued provider partner in serving Trillium, Health Net and Wellcare members!

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Effective October 1, 2025: Wellcare Medicare Prior Authorization Change Summary

Effective October 1, 2025, Wellcare By Health Net and Wellcare By Trillium Advantage are notifying all participating Medicare providers that prior authorization will no longer be required for a series of computed tomography (CT) and transthoracic echocardiogram procedure codes.

The comprehensive list of procedure codes affected by this notification are provided below:

Procedure Codes No Longer Requiring Prior Authorization Effective October 1, 2025

• Chest CT: 71250, 71260, 71270, 0722T
• CT for Low Dose Lung Cancer Screening: 71271
• CT of the Pelvis and Abdomen: 74176, 74177, 74178, 0722T
• Transthoracic Echocardiogram: 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93356

Please Note:

• Non-participating providers require authorization for all HMO services, except where indicated. A complete CPT/HCPCS code list can be viewed in the online Medicare Prior Authorization Tool.
• It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.
• Please verify eligibility and benefits for all members prior to rendering services. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered.

For additional assistance, please contact your assigned health plan Provider Engagement Administrator:

• Trillium and Wellcare By Trillium Advantage Provider Regional Rep Contacts
• Wellcare By Health Net Provider Regional Rep Contacts