Oregon Health Authority: Oregon Health Plan Permanent Rule Filings (OAR chapter 410) · July 1, 2026 · Primary source
121-changes-07012026.pdf: OARs 410-121-0030 410-121-0040 amended to update the Oregon Medicaid Pharmaceutical Services Prior Authorization Criteria and Oregon Medicaid Preferred Drug List, implementing recommendations from the Pharmacy and Therapeutics Committee. No public comment was received.
Summary
The Oregon Health Authority filed a permanent administrative order on June 29, 2026, effective July 1, 2026, amending OARs 410-121-0030 and 410-121-0040 to update the Oregon Medicaid Preferred Drug List and Prior Authorization Criteria for fee-for-service recipients, implementing recommendations from the Pharmacy and Therapeutics Committee. The updated PDL, dated July 1, 2026, is incorporated by reference and published at www.orpdl.org, replacing the April 1, 2026 version. The PA Criteria Guide is also updated to a July 1, 2026 version, replacing the June 1, 2026 version.
What this may mean
Oregon Health Plan fee-for-service pharmacy providers and prescribing practitioners must comply with the updated PDL and PA criteria effective July 1, 2026, with non-preferred drugs requiring prior authorization under OAR 410-121-0060 and new drugs in previously evaluated classes remaining non-preferred until P&T review. EPSDT exceptions to coverage restrictions are preserved under OAR 410-141-3820, ensuring that children's coverage mandates override PDL-based denials where EPSDT applies.
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