Pharmacy resources

The formulary list provides a directory of all the preferred medications currently approved for Health Share/CareOregon members. Use the link below to view the formulary in PDF format.

 

• CareOregon OHP formulary (updated 4/21)

 

You can search for a drug in one of the following ways:

• Find the drug listed in the formulary PDF index.
• In the PDF file, enter the drug name into the search box located in the menu.
• Call Customer Service at 503-416-4100, toll-free 800-224-4840 or TTY 711.

 

Note: If you are a provider looking for the CareOregon Advantage formulary, please visit the CareOregon Advantage website.

 

Formulary updates

CareOregon makes regular formulary updates. Use the links below to view the most recent changes in PDF format.

April 1, 2021
CareOregon (OHP) Formulary Update

July 1, 2020
Authorization Guidelines - Injectable Drugs for Bleeding and Clotting Disorders

April 1, 2021
Authorization Policy - Injectables/Medications Administered Under the Medical Benefit

April 1, 2021
CareOregon (OHP) Formulary Updates - New Generics

June 6, 2019
New Restrictions to Acute Opioid Prescribing

April 1, 2018
CareOregon (OHP) and CareOregon Advantage (Medicare) - Vaccine Coverage Guide

January 1, 2017
CareOregon (OHP) Formulary Updates - Opiates

Policies and forms can be downloaded using the links below. If you have any questions or are unable to locate the form you need, please contact Provider Customer Service at the numbers above.

If you have questions regarding your CareOregon contract or would like to schedule training, please contact your Provider Relations Specialist.

 

Pharmacy policies

• CareOregon OHP Prior Authorization Use Criteria (updated 4/2021)

 

Medicaid and Medicare

• Home Infusion Prior Authorization 
• Prior Authorization and Formulary Exception Request form (OHP only)
• Injectable Medication Administered by Provider Authorization form
• Chemotherapy Prior Authorization and Formulary Exception Request form (OHP)
• Hepatitis C Therapy form (OHP Only)
• Nutritional Supplement Medication Request form
• Sample Medication Contract (OHP and Medicare)
• Synagis Medication Request form
• Pharmacy Provider Reconsideration Request form
• Oregon Medicaid ID Pharmacy Application form

 

Medicare only

• Home Infusion Prior Authorization 
• Prior Authorization and Formulary Exception Request form (Medicare only)
• Prior Authorization and Formulary Exception Request form (Provided by Medicare)
• Hospice Prior Authorization form (Medicare Part D)
• Part D Vaccines Administered in the Medical Office Authorization & Reimbursement form

Pharmacy policy updates and other forms

• Authorization Policy-Injectables/Medications Administered Under the Medical Benefit (Updated 4/2021)
• Authorization Guidelines - Injectable Drugs for Bleeding and Clotting Disorders (Updated 7/2020)

 

Treatment Pathways

• CareOregon COPD Treatment Pathway
• CareOregon Diabetes Treatment Pathway

Additional resources

• Provider Policies and Forms
• CareOregon Provider Support
• Best Practice Guidelines
• Opioid Prescribers Guidelines (PDF)

Obtaining a complete list of a patient’s medications can be difficult. It can be equally hard to find out how patients feel their meds are working, and how they are actually taking them. There may be medication-related problems that can be avoided by asking the right questions. It’s not always easy for patients to understand how to take their medications, especially when there are many prescriptions from several prescribers. Pill bottles don’t always show the name of the indication that they are meant to treat. Using the MEDS Chart helps patients voice how they feel their medications are working for them, and to work more closely with caregivers and clinicians to:

• Discover if medications are working.
• Find out what’s really going on with adherence.
• Improve medication safety.
• Promote better health outcomes.

The MEDS Chart helps patients reinforce the reason for taking a medication, allowing them to better express how they feel about taking it and express any concerns they have.

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.

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.