News and updates
Medicaid Grievance and Appeals policies
These updated documents contain policy guidance for the Medicaid Grievance and Appeals System. Grievances Appeals and HearingsMember Information and Education RequirementsNotice of Adverse...
July 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...
May is Mental Health Awareness Month
According to the National Institute of Mental Health, more than 59 million people live with a mental illness, and it’s estimated that only half receive treatment. To mark Mental Health Awareness...
Helping older patients live their best lives
As patients age, many will quietly accept changes in their activity level, balance, and cognition as inevitable aspects of growing older. But these issues (and others such as...
May 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...
Changes to utilization management prior authorization submission requirements (Medicaid)
We would like to inform you of changes to utilization management prior authorization submission requirements for PacificSource Community Solutions (Medicaid). Effective...
2025 Community Capacity-Building Funding for HRSN services
The Oregon Health Authority (OHA) will be distributing Community Capacity Building Funding (CCBF) to coordinated care organizations (CCOs) interested in providing Health-Related Social Needs (HRSN)...
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...