News and updates
Mental Health/Substance Use Disorder – prior authorization change
PacificSource has removed the prior authorization requirement for mental health and substance use disorder residential and partial hospitalization treatment. This change is for our commercial members...
New Radiology Program Effective April 1, 2022
Effective April 1, 2022, PacificSource will transition the review of all outpatient diagnostic imaging services for PacificSource Community Solutions members to AIM Specialty Health.
Your...
An end to surprise medical bills
New legislation shields consumers from unexpected charges
Starting January 1, 2022, the federal No...
March Drug List Change Notification
Updates on Existing Criteria
March 2022. The following changes to criteria are effective March 22, 2022:
Prior Authorization Criteria – Clinical Updates...
SNF Enhanced Rates
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...
Pharmacy Coverage Updates Effective March 15, 2022
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...
On Behalf of OHA - Funding Opportunity: Clinical Supervision Program for Behavioral Health Providers
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...
February Drug List Change Notification
Updates on Existing Criteria
February 2022. The following changes to criteria are effective February 22, 2022:
Prior Authorization Criteria – Clinical Updates...
January 2022 Drug List Change Notification
Updates on Existing Criteria
January 2022. The following changes to criteria are effective January 22, 2022:
Prior Authorization Criteria – Clinical Updates...
December 2021 Drug List Change Notification
Updates on Existing Criteria:
December 2021. The following changes to criteria are effective December 22, 2021:
Prior Authorization Criteria – Clinical Updates...