Announcements
Featured Announcements
Important Notice Regarding Prior Authorizations for MP.PA.147
UPMC Health Plan previously communicated that prior authorizations would be required under policy Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 effective June 1, 2025. However, the prior authorization requirement will be paused until Sept. 1, 2025.Jul. 2025Important Notices
Clinical documentation required for hip, knee, and shoulder prior authorizations
As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.Jul. 2025Important Notices
Recent Announcements
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
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
Feedback sought on your experience with UPMC Health Plan
You may be invited to participate in a 2025 Press Ganey provider satisfaction survey, which will begin next month. This survey will be given to a random sampling of in-network primary care providers.Jul. 2025Important Notices
Feedback sought on your experience with UPMC Health Plan
You may be invited to participate in a 2025 Press Ganey provider satisfaction survey, which will begin next month. This survey will be given to a random sampling of in-network primary care providers.Jul. 2025Important Notices
Understanding MP.PA.147
Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policyJul. 2025Important Notices
Understanding MP.PA.147
Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policyJul. 2025Important Notices
Featured Announcements
Important Notice Regarding Prior Authorizations for MP.PA.147
UPMC Health Plan previously communicated that prior authorizations would be required under policy Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 effective June 1, 2025. However, the prior authorization requirement will be paused until Sept. 1, 2025.Jul. 2025Important Notices
Clinical documentation required for hip, knee, and shoulder prior authorizations
As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for hip, knee, and shoulder procedures in accordance with its established policies and procedures, in addition to CMS requirements that medical record documentation must support the medical necessity of the services requested.Jul. 2025Important Notices
Recent Announcements
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
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
Feedback sought on your experience with UPMC Health Plan
You may be invited to participate in a 2025 Press Ganey provider satisfaction survey, which will begin next month. This survey will be given to a random sampling of in-network primary care providers.Jul. 2025Important Notices
Feedback sought on your experience with UPMC Health Plan
You may be invited to participate in a 2025 Press Ganey provider satisfaction survey, which will begin next month. This survey will be given to a random sampling of in-network primary care providers.Jul. 2025Important Notices
Understanding MP.PA.147
Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policyJul. 2025Important Notices
Understanding MP.PA.147
Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policyJul. 2025Important Notices