Important: Expedited appeals fax requirement

Jan. 2026Important Notices

Please remember that you must adhere to the designated process for submitting expedited appeals to have them processed in a timely manner. Follow these guidelines to help you successfully submit expedited appeals:

  • Submit by fax only: You must submit all expedited appeal requests by fax to 412-454-7920.
  • Avoid email/mail: Submitting expedited appeals by email or mail will cause processing delays and may prevent completion within the required 48-hour time frame.
  • Remember all required documentation: All expedited provider appeals must include the Expedited Medical Necessity Appeal Request Form available on the UPMC Health Plan website.

Failure to follow this process may result in processing delays. For more information on the process, view the Provider Manual – Chapter B, Provider Disputes.

Recent Announcements

CME Webinar Series: Introducing Physicians and their teams to Value-Based Health Care

Please join us for a new CME-accredited webinar series on value-based care. This series is designed to introduce practicing physicians and their teams to value-based health care. Over the course of six sessions, we will define the components of value and identify the tools necessary to deliver high-value care for a population.
Feb. 2026Education/Webinars

Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions

Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.
Feb. 2026Education/Webinars

February 2026 UPMC for You and UPMC Community HealthChoices formulary update

Pulmicort Flexhaler has a new distributor, Rubicon Holding. National Drug Codes (NDCs) for Pulmicort Flexhaler from Rubicon Holding are not included in the Medicaid Drug Rebate program and are not covered under the Medicaid Prescription Drug Program. Pulmicort Flexhaler NDCs from the previous manufacturer, H2 Pharma, have been discontinued but may be billed/dispensed until supplies are exhausted.
Feb. 2026Pharmacy Updates