Pharmacy resources

Drug list (formulary)

Bi-Mart Pharmacy closure: Click here to read more.

The drug list (or formulary) is a directory of all preferred medications approved for Columbia Pacific members. This list is administered and provided by CareOregon. To download and view the drug list, click on the link.

2025 Columbia Pacific CCO OHP drug list (formulary)

Download a machine-readable format (JSON) of the Formulary

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

1. Find the drug listed in the formulary/PDF index.
2. In the PDF file, enter the drug name into the search box located in the menu.
3. Call Customer Service for assistance in finding a drug.

Formulary updates

Columbia Pacific makes regular formulary updates when necessary. These usually occur monthly.

• Formulary Update (PDF, updated June 1, 2025)
• Formulary Updates - New Generics (PDF, effective April 1, 2025)
• CareOregon (OHP) and CareOregon Advantage (Medicare) - Vaccine Coverage Guide

Policies: Pharmacy

• OHP Prior Authorization Use criteria

Forms: Pharmacy

• Home Infusion Prior Authorization
• Prior Authorization and Formulary Exception Request form (OHP only)
• Injectable Medication Administered by Provider Authorization form
• Hospice Prior Authorization form
• Hepatitis C Prior Authorization Request form (OHP only)
• Nutritional Supplement Medication Request form

Policy updates and other forms: Pharmacy

• Authorization Policy-Injectables/Medications Administered Under the Medical Benefit (Updated 6/2025)
• Authorization Guidelines - Injectable Drugs for Bleeding and Clotting Disorders (Updated 3/2024)
• HepC DUR Provider Update

MAP ID application form

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

Electronic prior authorization Q&As

• Network provider ePA Q&A
• Surescripts ePA Assistance Guide

Treatment Pathways

• CareOregon Diabetes Treatment Pathway
• CareOregon Advantage Diabetes Treatment Pathway
• CareOregon Asthma Treatment Pathway - Pediatrics and Adults

Specialty pharmacy network

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

Specialty Drugs included in the FMH Program

A list of specialty drugs 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:

• Phone: 877-787-0520
• Email: prescribers@freemarkethealth.com

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.