Beginning November 13, 2023, PacificSource will use different criteria for level-of-care decisions for mental health treatment (including inpatient, residential, partial...
Clarification and update. See frequently asked questions below.
Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have...
Updates on Existing Criteria
December 2023. The following changes to criteria are effective December 22, 2023:
Prior Authorization Criteria – Clinical Updates...
Here’s what you need to know:
Coverage of Humira (adalimumab) through PacificSource Community Solutions will change to other, biosimilar formulations.
Will I still be able to prescribe Humira?...
PacificSource Community Solutions (Medicaid) allows a 20-day skilled nursing facility (SNF) stay for individuals who qualify for skilled care. Prior authorization is not required for admission to a...
Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have received 26 or more therapy/counseling...