News and updates
Pharmacy coverage updates effective May 15, 2024 (Medicaid)
We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after May 15, 2024....
Community Capacity-Building Funding for HRSN services
Oregon is distributing Community Capacity Building Funding to organizations interested in providing Health-Related Social Needs (HRSN) benefits such as climate-related supports, housing supports, and...
Paxlovid™ is available to most PacificSource members at no cost, or at a discount
We're pleased to inform you that PacificSource members are eligible to enroll in the PAXCESS™ Patient Support Program through Pfizer. A current prescription...
Pharmacy coverage updates effective February 15, 2024 (Medicaid)
We have recently updated our prior authorization list and coverage policies for Medicaid patients. This change is effective for dates of service on or after February 15, 2024....
New process for claim-status checks
All claim-status checks must be completed using our secure provider portal, InTouch for Providers (OneHealthPort). We will no longer accept Claim Status Request forms submitted via...
Prior authorization requirement changes effective January 1, 2024 (Medicaid)
Certain codes will require prior authorization for Oregon Medicaid members.
Behavioral Health treatment reviews required in 2024
Clarification and update. See frequently asked questions below.
Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have...
Pharmacy coverage updates effective November 15, 2023 (Medicaid)
We have recently updated our prior authorization list and coverage policies. This change is effective for dates of service on or after November...
Humira coverage is changing for Medicaid members
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?...
Stay extensions available for members in skilled nursing facilities (Medicaid)
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...