Important update: InterQual Connect Prior Authorizations
Mar. 2022Important Notices
"As a reminder, prior authorizations for imaging and cardio procedures previously managed by Health Help will resume formal clinical reviews effective March 1, 2022. At this time there is no change to MSK/Orthopedic reviews.
Please ensure that prior authorization requests are submitted with complete information to increase the likelihood that they will be auto approved, eliminating the need for manual review and delayed authorizations."
Please ensure that prior authorization requests are submitted with complete information to increase the likelihood that they will be auto approved, eliminating the need for manual review and delayed authorizations."
Recent Announcements
October 2025 UPMC for You and UPMC Community HealthChoices formulary update
Effective Oct. 1, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to nonparticipation in the Medicaid Drug Rebate Program.Oct. 2025Pharmacy Updates
Voluntary nationwide recall: Ocaliva (Intercept – September)
Intercept Pharmaceuticals, Inc. is voluntarily withdrawing Ocaliva® (obeticholic acid) from the market. Ocaliva is used to treat a rare liver disease called primary biliary cholangitis (PBC).Oct. 2025Pharmacy Updates
HelpScript service helps patients enroll in manufacturer copay assistance programs
End-to-end provider support helps ensure a smooth submission processOct. 2025Important Notices