News and updates

Effective 11/11/2022 PacificSource Community Solutions will no longer pay/reimburse for CPT G0279 (Diagnostic digital breast tomosynthesis; unilateral or bilateral). CPT code G0279 has not been an...

Effective for dates of service on and after March 11, 2023, AIM Specialty Health® (AIM) will transition to an updated set of Clinical Appropriateness Guidelines. 
 
PacificSource...

Sharing on behalf of OHA:  Oregon will not renew the longstanding waiver around EPSDT for children. The decision comes as a result of clear feedback from the community, advocates, children's...

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 policies. These...

Effective October 1, 2022, a prior authorization requirement will be added to Durable Medical Equipment (DME) that are not on OHA's fee schedule, are set to manual pricing, and/or are designated as...

Pre authorization requirement update Effective August 29, 2022 pre authorization is required for codes 96116, 96121, 96132, 96133, 96136, 96137, and 96146 Please visit the authorization grid to...

Prior Authorization requirement on CPT 97010 - Effective 8/19/22

OHA distributed a news release on June 15th indicating that new rules made by the state Legislature’s passage of HB 2359 during the 2021 session related to use of qualified or certified health...

Dear Behavioral Health Providers, We want first to thank you for your continued care of our members. We have received several questions from our Behavioral Health provider partners requesting more...

Starting July 1, 2022, people who are 19-25 or 55 and older may be eligible for full Oregon Health Plan (OHP) and other medical assistance benefits regardless of their immigration...