News and updates
March 2025 Community Solutions (Medicaid) formulary and coverage policies notification
We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies.We have recently updated our prior authorization list and coverage...
Pharmacy coverage for 90-day medications now available via retail (Medicaid)
PacificSource Community Solutions (Medicaid) members now have access to 90-day supplies of certain medications via retail in addition to mail order. This change gives your patients more...
December 2024 Formulary Provider Notification Pharmacy Coverage Updates
We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies.We have recently updated our prior authorization list and coverage...
Behavioral Health treatment reviews required in 2024
Clarification and update. See frequently asked questions below.Effective January 1, 2024, PacificSource began completing utilization management reviews for...
November 2024 Community Solutions formulary and coverage policies notification
We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies.We have recently updated our prior authorization list and coverage...
Revised coding policies for Emergency Department outpatient facility Evaluation and Management
As part of our continued efforts to reinforce accurate coding practices, we are revising the current Emergency Department (ED) outpatient facility Evaluation and Management (E/M) coding reimbursement...
Pharmacy coverage updates, effective September 15, 2024 (Medicaid)
We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after September 15, 2024.Summary of changes...
Information for HRSN service providers
Here’s what providers should know if they want to provide health-related social needs (HRSN) services.Qualifications and process for becoming an HRSN service providerTo become an HRSN service...
Pharmacy coverage updates effective May 15, 2024 (Medicaid)
We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after May 15, 2024....
Community Capacity-Building Funding for HRSN services
Oregon is distributing Community Capacity Building Funding to organizations interested in providing Health-Related Social Needs (HRSN) benefits such as climate-related supports, housing supports, and...