Important announcement – Telehealth submissions

Sep. 2025Important Notices

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. 

Due to a lapse in federal authorization for telehealth claims in Medicare, beginning on 10/1/2025 UPMC Health Plan will temporarily hold telehealth claims submitted to UPMC for Life Medicare Advantage for future processing.  UPMC Health Plan anticipates, but cannot guarantee, that resolution of the federal government shutdown will result in retroactive allowance of telehealth claims in Medicare, at which time all UPMC for Life telehealth claims will be processed according to our standard coverage policies. We will continue to monitor the situation and provide updates as soon as reasonably practicable. 

Recent Announcements

Voluntary nationwide recall: Atorvastatin (Alkem – October)

Ascend Laboratories LLC is recalling multiple lots of Atorvastatin Calcium Tablets USP. Atorvastatin is used for the treatment of high cholesterol and to reduce the risk of certain cardiovascular events, such as heart attack and stroke.
Nov. 2025Pharmacy Updates

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