News and updates
Healthier Oregon Program Starting July 1, 2022
Starting July 1, 2022, people who are 19-25 or 55 and older may be eligible for full Oregon Health Plan (OHP) and other medical assistance benefits regardless of their immigration...
Oregon Medical Board warns of phone scams
PacificSource has been made aware of a phone scam claiming to be the Oregon Medical Board, asking for personal information. The Oregon Medical Board has released an official notice on these...
July 2022 Drug List Change Notification
Updates on Existing Criteria
July 2022. The following changes to criteria are effective July 22, 2022:
Prior Authorization Criteria – Clinical Updates
Carglumic...
PacificSource teams with data validation experts BetterDoctor (updated May 19, 2022)
Update May 19, 2022
PacificSource Health Plans is committed to supplying members with accurate, up-to-date directories of our network providers. Last year, PacificSource...
Pharmacy Coverage for 90-day Medications
Community Solutions members now have access to 90-day supplies of certain medications via mail order. This allows members to receive extended day supplies delivered directly to them by CVS Caremark...
Prior Authorization Requirement Removed for CPT 97129 - Effective April 15, 2022
Effective April 15, 2022, CPT 97129 will no longer require a prior authorization for Medicaid, PacificSource Community Solutions.
97129 - Therapeutic interventions that focus on cognitive...
June 2022 Drug List Change Notification
Updates on Existing Criteria
June 2022. The following changes to criteria are effective June 22, 2022:
Prior Authorization Criteria – Clinical Updates
Abilify...
Continuous Glucose Monitoring - prior authorization required
Effective June 15, 2022, PacificSource will require prior authorization for Continuous Glucose Monitoring for members on our commercial plans. This change pertains to CPT codes E2102, K0554,...
Telehealth Place of Service Code 10 - Updated Information
On March 25, 2022, a notice was posted stating that Oregon Health Authority (OHA) made the determination that POS 10 for telehealth will no longer be recognized for Medicaid claims. OHA has now...
Telehealth Place of Service Code 10 - Effective Immediately
Oregon Health Authority (OHA) recently made the determination that POS code 10 for telehealth will no longer be recognized for Medicaid claims billing. PacificSource is following this guidance...