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...
News and updates
Additional August 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaAugust 2025. The following changes to criteria are effective August 22, 2025: Prior Authorization...
July 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaJuly 2025. The following changes to criteria are effective July 22, 2025: Prior Authorization...
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...
Stelara coverage is changing for your PacificSource patients
Here’s what you need to know:Coverage of Stelara (ustekinumab) through PacificSource Health Plans will change to biosimilar formulations.
Will I still be able to prescribe...
Will I still be able to prescribe...
August 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaAugust 2025. The following changes to criteria are effective August 1st, 2025:Prior Authorization...
Additional June 22nd Drug List Changes (Commercial)
Updates on Existing CriteriaJune 2025. The following changes to criteria are effective June 22nd, 2025:Prior Authorization Criteria...
Continued access to care through OHSU and PeaceHealth
Great news: Continued access to care through OHSU and PeaceHealthWe’re excited to share that we’ve reached new agreements with both OHSU and PeaceHealth...
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...