News and updates

Updates on Existing Criteria June 2023. The following changes to criteria are effective June 22, 2023:  Prior Authorization Criteria – Clinical Updates...

After a three-year pause, the process of checking member eligibility for renewing Medicaid health insurance coverage has begun again. It’s estimated that anywhere between 5 and 15 million people are...

Updates on Existing Criteria May 2023. The following changes to criteria are effective May 22, 2023:  Prior Authorization Criteria – Clinical Updates...

The Centers for Disease Control, Oregon Health Authority, and the Centers for Medicare and Medicaid Services recommend clinicians carefully assess benefits and risks of prescribing high doses of...

The Oregon Health Leadership Council (OHLC) has created a guideline document for Telehealth Service Recommendations for Behavioral Health. ...

PacificSource has updated the following clinical policies: Instrumented Spinal Surgery Ocular Remodeling Sleep Disorder Treatment See our Clinical policies and practice guidelines for the...

Updates on Existing Criteria April 2023. The following changes to criteria are effective April 22, 2023:  Prior Authorization Criteria – Clinical Updates...

Effective April 1, 2023, the following HCPC codes will require prior authorization (PA) when using the Durable Medical Equipment (DME) benefit. A9276 A9277 A9278 E2102 E2103

Your commercial and Medicare clients may be asked to participate in the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey is overseen by a company called Press...

Updates on Existing Criteria March 2023. The following changes to criteria are effective March 22, 2023:  Prior Authorization Criteria – Clinical...