News and updates | PacificSource

December 17, 2025

PacificSource D-SNP Update for Lane County and the Portland Metro Area

Beginning in 2026, PacificSource will discontinue its D-SNP plans in Lane County and the Portland metro area. This decision was made with members at the center. D-SNP is designed...

Medicaid/OHP Providers

December 08, 2025

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;...

Providers

December 08, 2025

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...

Medicaid/OHP Members Providers

December 04, 2025

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...

Providers

November 10, 2025

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:...

Individual & Family, and Employer Medicaid/OHP Providers

October 20, 2025

December 2025 Drug List Change Notification (Commercial)

Updates on Existing CriteriaDecember 2025. The following changes to criteria are effective December 22, 2025:
Prior Authorization...

Individual & Family, and Employer Members Providers

October 17, 2025

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...

Medicaid/OHP Providers

October 06, 2025

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...

Medicaid/OHP Members Providers

September 29, 2025

Montana State Based Drug List Change Notification (Commercial)

Updates on Existing CriteriaOctober 2025. The following changes to criteria are effective October 1, 2025:
Removed from Formulary...

Individual & Family, and Employer Members Providers

August 19, 2025

October 2025 Drug List Change Notification (Commercial)

Updates on Existing CriteriaOctober 2025. The following changes to criteria are effective October 22, 2025:
Prior Authorization...

Individual & Family, and Employer Members Providers