Formulary updates effective Jan. 1, 2026
Dec. 2025Pharmacy Updates
Please be aware as of January 2026, there will be updates impacting formularies for all lines of business, coverage of adalimumab products, coverage of continuous glucose monitors (CGM), and billing processes for hyaluronate intra-articular injections and select intravenous and subcutaneous products. Please review the full details that include additional information on each change.
Recent Announcements
PA DOH Antibiotic Stewardship Resources
Order antibiotic stewardship resources at no costJun. 2026Important Notices
Medical device correction: Omnipod (Insulet – May 2026)
Insulet Corporation Inc. has announced a medical device correction for certain Omnipod Pods. These pods are wearable devices that are used to deliver insulin.Jun. 2026Pharmacy Updates
Clinical documentation required for medical policy prior authorizations
As you know, UPMC Health Plan requires certain clinical documentation/notes in support of a request for prior authorization for the listed procedures below 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.Jun. 2026Important Notices