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

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

CME Webinar: American Foundation for Suicide Prevention’s ‘Talk Saves Lives’ Program

Please join us on Tuesday, April 28, from noon to 1 p.m. for “Talk Saves Lives: An Introduction to Suicide Prevention.” This live, CME-accredited webinar is the American Foundation for Suicide Prevention’s flagship suicide prevention education program. It covers the scope of this leading cause of death, warning signs and risk factors for suicide, and strategies to prevent it.
Feb. 2026Education/Webinars

Training Webinar: Conversio Health COPD Management Program

Please join us for a live training webinar by UPMC Health Plan that will provide an overview of a comprehensive COPD management program from Conversio Health.
Jan. 2026Education/Webinars