Provider updates

We are sharing an update on the Legacy Health PacificSource transition. For further questions please reach out to provider relations at metroprs@careoregon.org.

What is changing?

Effective January 1, Legacy Medical Group will officially join the CareOregon contracted provider network, serving members throughout the tri-county metro area. 

Additionally, members currently enrolled in Health Share of Oregon Legacy Health PacificSource Medicaid physical health plans will be automatically transitioned to CareOregon Integrated Care Network (ICN) effective January 1, 2026. 

Why is this change happening?

Legacy Health PacificSource is leaving the Medicaid market in the Metro region. Members will have expanded access to care with this change as they will have a wider network of in-network providers to choose from.

What can providers do to ensure a smooth transition for members?

In most cases, members can continue receiving care from their existing providers. HSO-CareOregon sent letters with the notice of the health plan change and what to expect to Legacy Health PacificSource members the week of December 1. If a member needs a specialty provider, please call Provider Customer Service 503-416-4100 or 800-224-4840 (press option 3 for provider) where they will follow the standard referral process to Care Coordination if needed to ensure proper access and support.

When will prior authorizations be available?

Providers do not need to submit a new prior authorization for January 1, 2026 - March 31, 2026 for services previously approved by Legacy Health PacificSource; Providers should submit claims for payment and CareOregon will honor the prior authorization. Services not previously approved by Legacy Health PacificSource or services performed on or after April 1, 2026 will follow CareOregon prior authorization rules and processes. There is no need to attach or show proof of prior approval on claims for dates of service January 1, 2026 - March 31, 2026.

What happens to the members under Legacy Health PacificSource?

Legacy Health PacificSource members will automatically be enrolled with CareOregon to minimize disruption. In most cases, members will continue to be assigned to the same primary care clinic as their Legacy Health PacificSource assignment.

Member ID cards will be mailed directly to members. ID cards will be sent in batches, so not all members will receive their cards by January 1. During the gap between January 1 and when members receive their ID cards, members may need to inform the pharmacy that they now have CareOregon insurance. Pharmacies or members can call the CareOregon pharmacy help desk at 844-245-0449 for updated information needed to process the claim and fill the prescription.

Members can view their ID cards in the CareOregon mobile app and web portal as of January 1, 2026.

Where can providers go for more information?

For further questions about this transition please reach out to Provider Customer Service at 503-416-4100 or 800-224-4840. Press option 3 for provider.

For more detailed questions, please email metroprs@careoregon.org