News and updates
May 2026 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...
Hospital observation services: billing and reimbursement policy updates
Effective July 1, 2026, PacificSource will implement updates to its policies regarding hospital outpatient observation services. Key considerations when billing for these services include the...
Pharmacy prior authorization extension notification
As part of our effort to improve access to affordable healthcare, our Pharmacy department is reducing administrative burden by extending the approved date range for certain maintenance...
Prior authorization changes for February 1, 2026 – Medicare and Medicaid
Medicare:Starting February 1, 2026, these services with the listed billing codes will require prior authorization.C9781 - Arthroscopy, shoulder, surgical;...
January 2026 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...
Update on PacificSource’s Lane County CCO Participation
PacificSource has made the difficult decision to exit the Lane County Coordinated Care Organization (CCO). This follows months of good-faith collaboration with the Oregon Health Authority (OHA...
Medicaid and Commercial Prior Authorization Changes
Commercial and Medicaid: Starting January 1, 2026, these services with the listed billing codes will require prior authorization for both Commercial and Medicaid plans:...
Medicaid Peer delivered services policy update
PacificSource Community Solutions has updated the peer-delivered services policy effective January 1, 2026.Clarifying criteria for service eligibility for peer-delivered services, including medical...
November 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...
September 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...