Pharmacy Information for Providers

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The Western Oregon Advanced Health Formulary is a list of medications that are covered for Western Oregon Advanced Health members. Some medications listed on the formulary require a prior authorization to ensure the least costly alternatives for treatment are utilized, and the condition being treated is funded for coverage by Oregon Health Plan.

Any medication may be requested for coverage, regardless of formulary status, through the prior authorization process.

Submission of a prior authorization request is not a guarantee of coverage, as certain requirements and criteria must be met in order for a prior authorization request to be approved.

Any prescription over $500 requires a prior authorization, even if the medication is on the Western Oregon Advanced Health Formulary.

Western Oregon Advanced Health is a mandatory generic plan, therefore, generic medications must be used when commercially available.

Mental Health medications are covered directly by the State Medical Assistance Program (MAP, previously known as the Division of Medical Assistance Programs or DMAP) as part of the mental health (or 7/11) carve-out.

Please contact Western Oregon Advanced Health Customer Service at (541) 269-7400 if you have any questions or need assistance.

Forms and Tools:

DIRE Risk Assessment Tool

Drug Use Criteria

Hep C Readiness to Refer Tool

Hep C Provider Letter

Medication Authorization Form

Drug Formulary:

2017 Printable Alphabetical

2017 Printable By Class

Other Resources:

Oregon State University College of Pharmacy Newsletter

Antibiotics Provider Blog

AWARE Facebook

BAH – HOW TO DISPOSE OF SHARPS CONTAINERS

Judicious Use of Antibiotics:  A Guide to Oregon Clinicians

Oregon Prescription Drug Monitoring Program (PDMP) User Access & Registration

Patient Information Sheets

Provider Resources

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