IMPORTANT UPDATE: Extending the current UPMC Health Plan utilization model for selected MSK, cardiology, and radiology codes

Jan. 2022Important Notices
Prior authorizations for procedures and imaging that were previously managed by HealthHelp (diagnostic imaging, cardiology, and MSK) will be approved until March 1st without review of clinical documentation. However, prior authorization requests must still be submitted for related claims to be paid. Please ensure that requests are submitted with complete information to increase the likelihood that they will meet criteria and be auto approved, eliminating the need for manual review and delayed authorizations.

Recent Announcements

Voluntary nationwide recall: Famotidine (Fresenius – November)

Fresenius Kabi USA, LLC is recalling three lots (6133156, 6133194, and 6133388) of Famotidine Injection, USP, 20 mg per 2 mL. Famotidine is used to treat excessive secretion of stomach acid or stomach ulcers.
Nov. 2025Pharmacy Updates

Medicaid provider update: High-cost Medicaid drug billing

Billing requirements for Medicaid-covered drugs
Nov. 2025Important Notices

Training Webinar: Conversio Health COPD Management Program

Please join us for a live training webinar for primary care providers and pulmonologists by UPMC Health Plan that will provide an overview of a comprehensive COPD management program from Conversio Health.
Nov. 2025Education/Webinars