March 2025 Drug List Change Notification (Commercial)
Updates on Existing Criteria March 2025. The following changes to criteria are effective March 22, 2025:Prior Authorization Criteria –...
News and updates
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...
February 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaJanuary 2025. The following changes to criteria are effective January 22, 2025:Prior Authorization Criteria –...
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...
Behavioral Health treatment reviews required in 2024
Clarification and update. See frequently asked questions below.Effective January 1, 2024, PacificSource began completing utilization management reviews for...
January 2025 Drug List Change Notification (Commercial)
Updates on Existing CriteriaDecember 2024. The following changes to criteria are effective December 22, 2024:Prior Authorization Criteria –...
December 2024 Drug List Change Notification (Commercial)
Updates on Existing CriteriaDecember 2024. The following changes to criteria are effective December 22, 2024:Prior Authorization Criteria –...
November 2024 Community Solutions 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...
November 2024 Drug List Change Notification (Commercial)
Updates on Existing CriteriaNovember 2024. The following changes to criteria are effective November 22, 2024:Prior Authorization Criteria –...
Revised coding policies for Emergency Department outpatient facility Evaluation and Management
As part of our continued efforts to reinforce accurate coding practices, we are revising the current Emergency Department (ED) outpatient facility Evaluation and Management (E/M) coding reimbursement...