News and updates

New legislation shields consumers from unexpected charges    Starting January 1, 2022, the federal No...

Updates on Existing Criteria March 2022. The following changes to criteria are effective March 22, 2022: Prior Authorization Criteria – Clinical Updates...

OHA has recently updated the fee-for-service payment rates, and also included a new enhanced wage add-on rate for approved nursing facilities effective 10/1/2021. Those who qualify will be notified...

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 policies. These...

OHA has opened its first round of solicitations for the Clinical Supervision Program. This solicitation intends to provide financial awards to expand clinical supervision for behavioral health...

Updates on Existing Criteria February 2022. The following changes to criteria are effective February 22, 2022: Prior Authorization Criteria – Clinical Updates...

PacificSource will continue to cover the following COVID-related services, including those that are provided in an office setting, urgent care, or emergency room. These services will continue to cost...

Dear Member, the blog post below makes several references to COVID-19 benefits that will no longer be in effect as of May 11, 2023, due to the end of the federal public health emergency. While...

Part of being a “members first” health insurer is communicating clearly with members. That’s why we’re pleased to announce a redesign of the Explanation of Benefits (EOB) statement you receive when...

The Explanation of Benefits (EOB) is a statement that gives members important details on services performed, benefits paid, and payment responsibilities. That’s why we’re pleased to announce a...