Or. Admin. Code § 333-022-1070

Current through Register Vol. 64, No. 1, January 1, 2025

Section 333-022-1070 - Prescriptions

(1) Unless an exception applies under subsections (3)(a) or (b) of this rule, CAREAssist clients must use an Authority-approved CAREAssist in-network pharmacy for all:

(a) Medications not designated as acute on the CAREAssist formulary;

(b) Chronic care medications; and

(c) Medications paid for in full by the Authority

(2) The Authority must provide to each client a list of approved pharmacies and post the information on the CAREAssist website.

(3) A CAREAssist client may use a non-CAREAssist in-network pharmacy if:

(a) His or her insurance carrier requires use of a pharmacy that is not a CAREAssist in-network pharmacy; and

(b) He or she has provided the Authority with a copy of the insurance summary of benefits for that insurance plan and the requirement to use a non-CAREAssist in-network pharmacy is explicitly stated in that insurance summary.

Or. Admin. Code § 333-022-1070

PH 30-2014, f. 11-10-14, cert. ef. 12-1-14

Stat. Auth.: ORS 413.042, 431.250, 431.830

Stats. Implemented: ORS 431.250, 431.830