Pharmacy prior authorization extension notification
As part of our effort to improve access to affordable healthcare, our Pharmacy department is reducing administrative burden by extending the approved date range for certain maintenance...
News and updates
February 2026 Drug List Change Notification (Commercial)
Updates on Existing CriteriaThe following changes to criteria are effective by February 22, 2026:Prior Authorization Criteria – Clinical Updates...
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;...
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...
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...
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...
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...
Removed from Formulary...