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

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 policy
Jul. 2025Important Notices

Understanding MP.PA.147

Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy
Jul. 2025Important Notices

Register for the Oral Health in Your Pediatric Office CME -accredited webinar

Please join us for a live, CME-accredited webinar on Wednesday, Sept. 10 from noon to 1 p.m. that will provide an overview of oral health in your pediatric office. Providers with a(n) MD/DO, PA, CRNP, RN, or LPN may also apply for topical fluoride certification after completion of this course.
Jun. 2025Education/Webinars

Register for the Oral Health in Your Pediatric Office CME -accredited webinar

Please join us for a live, CME-accredited webinar on Wednesday, Sept. 10 from noon to 1 p.m. that will provide an overview of oral health in your pediatric office. Providers with a(n) MD/DO, PA, CRNP, RN, or LPN may also apply for topical fluoride certification after completion of this course.
Jun. 2025Education/Webinars

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

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 policy
Jul. 2025Important Notices

Understanding MP.PA.147

Understanding changes to the Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 policy
Jul. 2025Important Notices

Register for the Oral Health in Your Pediatric Office CME -accredited webinar

Please join us for a live, CME-accredited webinar on Wednesday, Sept. 10 from noon to 1 p.m. that will provide an overview of oral health in your pediatric office. Providers with a(n) MD/DO, PA, CRNP, RN, or LPN may also apply for topical fluoride certification after completion of this course.
Jun. 2025Education/Webinars

Register for the Oral Health in Your Pediatric Office CME -accredited webinar

Please join us for a live, CME-accredited webinar on Wednesday, Sept. 10 from noon to 1 p.m. that will provide an overview of oral health in your pediatric office. Providers with a(n) MD/DO, PA, CRNP, RN, or LPN may also apply for topical fluoride certification after completion of this course.
Jun. 2025Education/Webinars

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