Pharmaceutical Services Program
Find Oregon Administrative Rules and supplemental information administered by the Division of Medical Assistance Programs.
Recent Rule Filings
You can sort or filter by document type or effective date. You can also view Pharmaceutical Services Program rules as filed with the Secretary of State (please note that rules filed by the first of the month will not be posted on the Secretary of State website until the middle of the filing month).
|121-0040-081414||Temporary Rule Filing|
PA Criteria March 27, May 29, July 31, Sept 23, 2014 DUR/P&T Action
|Nprm-121-0040-091614||Notice of Rulemaking Hearing|
Amending Prior Authorization Guide - March 27, May 29, July 31, 2014 DUR/P&T Action
Rulemaking Hearing: September 16, 2014, 10:30 a.m., Room 173B
Last Opportunity for Public Comment: September 18, 2014, by 5 p.m.
|121-0030-09162014||Temporary Rule Filing|
Amending PDL-March 27, May 29, 2014 DUR/P&T Action
Supplemental information and guidelines
Also see our frequently asked questions about DMAP prescription coverage and Oregon Medicaid Pharmacy Quick Reference.
For resources provided by the OSU College of Pharmacy's Drug Use Review and Management (DURM) Program, including the Oregon State Drug Review, visit the DURM website.
Billing diabetic supplies
Oregon Medicaid PA Criteria
Preferred Drug List
Physical health drugs on this list do not require PA. Access the list using Epocrates Rx ("Oregon Medicaid - open card"), and access formularies for other payers, including OHP health plans. Lists before 2012 are in the administrative rulebooks.
Supplemental rebate information
Request to Change Pharmacy - For Pharmacy management Program clients
Prior Authorization Request for Pharmacy and Oral Nutritional Supplements
Other pharmacy links
OHA Pharmacy Services
Actual Average Acquisition Cost (AAAC) Weekly Rate Updates and AAAC rate review forms and processes
Oregon Prescription Drug Program - See OAR 410-121-2000 through 410-121-2065
CAREAssist - See OAR 410-121-3000
Oregon Prescription Drug Monitoring Program - See OAR 410-121-4000 through 410-121-4020
Pharmacy and Therapeutics Committee
Centers for Medicare and Medicaid Services
CMS Federal Upper Limits - CMS has published cumulative changes from 2002 through September 25, 2009 under "Changes made to Transmittal No. 37."
Medicaid Drug Rebate Program data files - Less-Than-Effective (LTE/IRS) drugs have a DESI indicator of 5 or 6.
Medicaid Drug Rebate List Updates
Sovereign States Drug Consortium (SSDC) website
Medicare Modernization Act (MMA) website
National Provider Identifier look-upAdded - All pharmacy claims should include the NPI of the prescribing provider in the prescriber ID field.
Who to call for help