Pharmacy resources

The Pharmacy Help Desk provides 24/7 technical assistance to pharmacy staff to resolve claim questions.

Formulary list

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

• Download CareOregon OHP formulary (PDF) - October 1, 2026
• Machine-readable format: CareOregon OHP formulary (JSON)
• Other languages:
  • Arabic
  • Dari
  • Simplified Chinese
  • Traditional Chinese
  • Russian
  • Spanish
  • Somali
  • Vietnamese

Updates

• View past Formulary updates - October 2026
• OHP Formulary Changes New Generics (PDF) - August 2025

PA criteria

• Prior Authorization Criteria

Physician Administered Drugs (Medical Benefit)

• OHP Injectable Auth Required List (PDF) - October 2026
• Vaccine Info Guide (PDF)

• Injectable Medication Administered by Provider Authorization form (PDF)

For submission, please follow the instructions on the form. You also can submit this form electronically using the provider portal. 

If you need to submit a prior authorization request for pharmacy related benefts, you can do so electronically, by phone or fax. Go to professionals.optumrx.com for more information on how to:

• Submit and track prior authorizations
• Access forms and reference materials
• Verify eligibility and pharmacy benefits

For information on how to navigate the OptumRx website: OptumRx Provider tools (PDF)

• More information on ePA changes
• How to submit an ePA
• For information on how to navigate the OptumRx website

• CareOregon Diabetes Treatment Pathway 2024 (PDF)
• Asthma Treatment Pathway (PDF)
• HIV PrEP Pathway (PDF)
• CareOregon Diabetes Resource Guide (PDF)

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.

• Free Market Health FAQ (PDF)

Specialty Drugs included in the FMH Program

• The CareOregon (Medicaid) Specialty Drug List (PDF) included in the FMH program will be updated periodically.

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:

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.

• MAP ID application form (PDF)

We want members to know that choosing the right pharmacy can make it easier for them to take their medications. To make things simple, we created a sharable Pharmacy 101 video. In the video, members will learn about the many pharmacy options available to them and how each may have a unique benefit to their care experience.

This video is available on the Medications page or on Youtube for easy sharing.

If you need to submit a prior authorization request for pharmacy related benefts, you can do so electronically, by phone or fax. Go to professionals.optumrx.com for more information on how to:

• Submit and track prior authorizations
• Access forms and reference materials
• Verify eligibility and pharmacy benefits

For information on how to navigate the OptumRx website: OptumRx Provider tools (PDF)