Announcements

Featured Announcements

Important announcement: UPMC Health Plan retires MP.PA.147

This communication is in regards to UPMC Health Plan Policy MP.PA.147 – Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older. UPMC Health Plan previously communicated that the prior authorization requirement under this policy would be paused until Sept. 1, 2025. However, policy MP.PA.147 has been retired, and this policy will no longer be implemented or active.
Aug. 2025Important Notices

Recent Announcements

The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.
Aug. 2025Important Notices

The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.
Aug. 2025Important Notices

CMS expands Medicare Advantage RADV audits to all eligible plans

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.
Aug. 2025What's New

CMS expands Medicare Advantage RADV audits to all eligible plans

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.
Aug. 2025What's New

Feedback sought on your experience with UPMC Health Plan

You may be randomly selected to participate in a 2025 Press Ganey provider satisfaction survey that will begin this month.
Aug. 2025Important Notices

Feedback sought on your experience with UPMC Health Plan

You may be randomly selected to participate in a 2025 Press Ganey provider satisfaction survey that will begin this month.
Aug. 2025Important Notices

Prescription for Wellness ~ Leveraging Insurance Carrier Resources to Optimize Patient Engagement Outcomes!

Prescription for Wellness is a nationally recognized, Six Sigma-developed best practice system that provides a convenient and effective way for providers to prescribe resources and support offered by UPMC Health Plan to their patients who are UPMC Health Plan members.
Aug. 2025Education/Webinars

Prescription for Wellness ~ Leveraging Insurance Carrier Resources to Optimize Patient Engagement Outcomes!

Prescription for Wellness is a nationally recognized, Six Sigma-developed best practice system that provides a convenient and effective way for providers to prescribe resources and support offered by UPMC Health Plan to their patients who are UPMC Health Plan members.
Aug. 2025Education/Webinars

Voluntary nationwide recall: Sucralfate (Nostrum – July)

Nostrum Laboratories, Inc. is recalling all lots of Sucralfate Tablets USP 1 gram. Sucralfate is used for the prevention and treatment of certain stomach ulcers.
Jul. 2025Pharmacy Updates

Receive consultations to better support the behavioral health needs of child and adolescent patients

The Telephonic Psychiatric Consultation Service Program (TiPS) is a Pennsylvania HealthChoices program that gives primary care providers access to free, on-demand consultations with child and adolescent psychiatrists, typically within 30 minutes. It is available to providers of children and adolescents who have Pennsylvania Medicaid, Children’s Health Insurance Program, or UPMC Health Plan commercial insurance.
Jul. 2025What's New

Featured Announcements

Important announcement: UPMC Health Plan retires MP.PA.147

This communication is in regards to UPMC Health Plan Policy MP.PA.147 – Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older. UPMC Health Plan previously communicated that the prior authorization requirement under this policy would be paused until Sept. 1, 2025. However, policy MP.PA.147 has been retired, and this policy will no longer be implemented or active.
Aug. 2025Important Notices

Recent Announcements

The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.
Aug. 2025Important Notices

The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.
Aug. 2025Important Notices

CMS expands Medicare Advantage RADV audits to all eligible plans

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.
Aug. 2025What's New

CMS expands Medicare Advantage RADV audits to all eligible plans

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a substantial expansion of its Risk Adjustment Data Validation (RADV) audit program for Medicare Advantage plans.
Aug. 2025What's New

Feedback sought on your experience with UPMC Health Plan

You may be randomly selected to participate in a 2025 Press Ganey provider satisfaction survey that will begin this month.
Aug. 2025Important Notices

Feedback sought on your experience with UPMC Health Plan

You may be randomly selected to participate in a 2025 Press Ganey provider satisfaction survey that will begin this month.
Aug. 2025Important Notices

Prescription for Wellness ~ Leveraging Insurance Carrier Resources to Optimize Patient Engagement Outcomes!

Prescription for Wellness is a nationally recognized, Six Sigma-developed best practice system that provides a convenient and effective way for providers to prescribe resources and support offered by UPMC Health Plan to their patients who are UPMC Health Plan members.
Aug. 2025Education/Webinars

Prescription for Wellness ~ Leveraging Insurance Carrier Resources to Optimize Patient Engagement Outcomes!

Prescription for Wellness is a nationally recognized, Six Sigma-developed best practice system that provides a convenient and effective way for providers to prescribe resources and support offered by UPMC Health Plan to their patients who are UPMC Health Plan members.
Aug. 2025Education/Webinars

Voluntary nationwide recall: Sucralfate (Nostrum – July)

Nostrum Laboratories, Inc. is recalling all lots of Sucralfate Tablets USP 1 gram. Sucralfate is used for the prevention and treatment of certain stomach ulcers.
Jul. 2025Pharmacy Updates

Receive consultations to better support the behavioral health needs of child and adolescent patients

The Telephonic Psychiatric Consultation Service Program (TiPS) is a Pennsylvania HealthChoices program that gives primary care providers access to free, on-demand consultations with child and adolescent psychiatrists, typically within 30 minutes. It is available to providers of children and adolescents who have Pennsylvania Medicaid, Children’s Health Insurance Program, or UPMC Health Plan commercial insurance.
Jul. 2025What's New

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