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;...
News and updates
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...
Continued access to care through St. Charles & Salem Health for Commercial and Medicare Members
Update on St. Charles Health System
We’re happy to share that PacificSource has reached agreements with St. Charles Health System for our Commercial plans in...
We’re happy to share that PacificSource has reached agreements with St. Charles Health System for our Commercial plans in...
Continued access to care through St. Charles Health System
We’re happy to share that PacificSource has reached agreements with St. Charles Health System for our Commercial plans in 2026 and 2027 and our Medicare plans in 2026.There...
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:...
December 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaDecember 2025. The following changes to criteria are effective December 22, 2025:
Prior Authorization...
Prior Authorization...
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...
Idaho 2026 Individual & Family Rate Changes
Idaho individual and family health plan rates are increasing in 2026.To learn more about the reasons behind these changes, review the justification for the proposed changes (PDF).
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...