Announcements
Featured Announcements
Important announcement – Telehealth submissions
As of October 1, 2025, UPMC Health Plan continues to accept the submission of telehealth claims. Providers may conduct telehealth visits for UPMC Health Plan members in all UPMC Insurance products. UPMC Insurance products include UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, UPMC for Kids CHIP plans, UPMC Community HealthChoices, and UPMC for You Medical Assistance plans.Sep. 2025Important Notices
Recent Announcements
October 2025 UPMC for You and UPMC Community HealthChoices Formulary Update
Effective October 1st, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to non-participation in the Medicaid Drug Rebate Program.Sep. 2025Pharmacy Updates
Biosimilar Medication Formulary Updates
Updates to formulary biosimilar medications for denosumab, eculizumab, and ustekinumab productsSep. 2025Pharmacy Updates
Voluntary nationwide recall: Cyclobenzaprine (Unichem – August 2025)
Unichem Pharmaceuticals (USA), Inc. is recalling one lot, lot GMML24026A, of Cyclobenzaprine Hydrochloride Tablets USP 10 mg. Cyclobenzaprine is used for the relief of muscle spasms from certain conditions.Sep. 2025Pharmacy Updates
CME Webinar: Evaluating Antimicrobial Stewardship Techniques in the Outpatient Setting
Please join us for a live, CME-accredited webinar on Tuesday, Nov. 4, from noon to 1 p.m. that will share an overview of evaluating antimicrobial stewardship techniques in the outpatient setting.Aug. 2025Education/Webinars
Voluntary nationwide recall: Lactated Ringers and 0.9% Sodium Chloride (B. Braun-Aug)
B. Braun Medical, Inc. is recalling two lots of Lactated Ringers Injection USP 1000 mL and 0.9% Sodium Chloride Injection USP 1000 mL. These are intravenous (IV) fluids commonly used in the hospital to treat dehydration and other conditions.Aug. 2025Pharmacy Updates
Understanding available resources for substance misuse and addiction
Information available on the internet can be overwhelming when searching on the topic of substance misuse and addiction. UPMC Health Plan has a dedicated webpage containing information and links to treatment service options, harm reduction services, and other supports. The webpage includes local, state, and national resources to help streamline the search process for members and their families who may be experiencing challenges related to substance misuse and addiction, and for providers who may be looking for information on how to best support their patients.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
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
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