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...
News and updates
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...
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...
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...