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Provider document update: Non-contracted Behavioral Health Fee Schedule effective June 1, 2025.

Pharmacy resources

Welcome to our pharmacy resources

Here you’ll find information about our Pharmacy Help Desk, formulary, policies and forms and more.

For Medicare materials, please visit the CareOregon Advantage Pharmacy benefits and resources page.

The Pharmacy Help Desk provides resources for providers, pharmacists, pharmacy technicians and supporting staff.

Pharmacy Help Desk

Toll-free:

800-224-4840

Hours:

8 a.m. to 5 p.m., Monday-Friday

OptumRx for after hours

Medicare members:

866-325-7344

Medicaid (OHP) members:

844-245-0449

Formulary list

The formulary list provides a directory of all the preferred medications currently approved for Health Share/CareOregon members.

Updates

PA criteria

Physician Administered Drugs (Medical Benefit)

CareOregon is partnering with Free Market Health (FMH) and OptumRx to enhance our specialty pharmacy network for our Medicaid members. Through FMH’s platform, our members are connected to an in-network specialty pharmacy that can best meet their needs by optimizing quality, access, and cost.

Specialty Drugs included in the FMH Program

About Free Market Health (FMH)

Free Market Health (FMH) is a healthcare technology company that orchestrates and optimizes the specialty drug fulfillment process for health plans, specialty pharmacies, and patients with its care-driven marketplace platform.

The FMH platform enables a dynamic referral process that facilitates a match between specialty pharmacies and authorized referrals based on quality and cost.

Prescribers can reach out to FMH to confirm a pharmacy or to check on the status of a member’s specialty referral:

Free Market Health (FMH)

Note: From time to time, prescribers may receive a request to transfer a prescription to a new specialty pharmacy as a result of this process.

Adverse events and errors

Be sure to report serious adverse events and medication errors. A medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice; health care products, procedures and systems, including prescribing; order communication; product labeling, packaging and nomenclature; compounding; dispensing; distribution; administration; education; monitoring and use."

  • Report serious adverse medication reactions, product quality problems and usage errors online at fda.gov/medwatch, by phone or by submitting a MedWatch 3500 form by mail or fax.
  • Report medication errors to CareOregon at 503-416-4100 or toll-free at 800-224-4840 from 8 a.m. to 5 p.m. Monday through Friday.

Medication safety

We encourage CareOregon providers to check the U.S. Food and Drug Administration MedWatch website and sign up for the FDA Drug Safety Newsletter to receive safety alerts via email. We will inform you if CareOregon takes any formulary actions in response to a safety alert.

CareOregon is a managed care plan contracted with the Oregon Health Authority (OHA). As a contracted plan, CareOregon is required to encounter all claims received to OHA. In order to encounter a claim, the rendering and billing providers must first be verified as eligible to receive payment by OHA and issued an ID number. This ID number is for the purposes of claim processing solely and does not imply you are contracting with CareOregon or OHA. By completing the application in its entirety, you are meeting minimum conditions for claim processing.

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