Novillus important dates and times

Dec. 2022Important Notices
Late December: The Partners Program Gaps in Care (CGMA) system will be updated. You will see membership through Dec. 15.

Dec. 31: You will be able to submit 2022 care gap and service event information to the CGMA until 11:59 p.m. EST.

Jan. 15: You will be able to submit reopened or rejected 2022 care gap and service event information to the CGMA until 11:59 p.m. EST. Service dates in 2023 will not be accepted at this time.

Jan. 16–March 5: The CGMA will be temporarily closed to prepare for the launch of the 2023 CGMA. You will not have access to the application during that time.

March 6: The 2023 CGMA—including 2023 care gaps and member rosters—will be available at 8 a.m. EST.

The delay in the system launch will allow claims received through January to be processed in February. The system will be updated to reflect 2023 gaps and new membership through Jan. 31, 2023.

Recent 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

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 products
Sep. 2025Pharmacy Updates