New specialty pharmacy program
Beginning August 1, 2025, CareOregon is partnering with Free Market Health (FMH) and OptumRx to enhance our specialty pharmacy network for our Medicaid members. Through FMH’s platform, members with select specialty prescriptions will be connected to an in-network specialty pharmacy through a streamlined referral process that optimizes quality, access, and cost.
In recent weeks, FMH and OptumRx began outreach for pharmacy network contracting. Prescribers may notice new specialty pharmacies serving our members. Pharmacy changes will be communicated to members directly. A member’s medication brand, type, and quantity will remain unchanged.
What is the impact on prescribers?
Prescribers should continue to follow their standard process to submit specialty medication referrals for prior authorization. Once authorized, FMH will receive the referral for management and match it to a specialty pharmacy best suited to service the member. The assigned pharmacy will have the CareOregon authorization to service the referral. Occasionally, prescribers may receive a request to transfer a prescription to a new specialty pharmacy.
For more information
Visit www.careoregon.org/providers/pharmacy-resources for more information on FMH and to view a list of specialty medications included in the FMH program. For health plan questions, contact CareOregon’s provider customer serviceat 800-224-4840, option 3.
Prescribers can reach out to FMH to confirm a pharmacy or to check the status of a member’s specialty referral at 877-787-0520 or via prescribers@freemarkethealth.com.
