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
Medicaid Renewal
Starting in 2027, some Medicaid recipients (ages 19–-64) will have new requirements to keep their coverage.Aug. 2026Important Notices
Provider Directory Updates and Required Attestation
As you know, UPMC Health Plan requires all providers to verify their provider directory information at least every 90 days (quarterly).Aug. 2026Important Notices
Voluntary nationwide recall: Tyenne (Fresenius – August 2026)
Fresenius Kabi is recalling one lot, lot 16UI07, of Tyenne® (tocilizumab-aazg) Injection 400 mg/20 mL (20 mg/mL) 20 mL vials. Tyenne is used for the treatment of certain arthritis conditions.Aug. 2026Pharmacy Updates