Important Notice Regarding Prior Authorizations for MP.PA.147

Jul. 2025Important Notices

UPMC Health Plan previously communicated that prior authorizations would be required under policy Diagnostic and Surveillance Colonoscopy, 18 Years Old and Older – MP.PA.147 effective June 1, 2025. However, the prior authorization requirement will be paused until Sept. 1, 2025.

Authorizations that have already been submitted will be entered without a review. Patient care should not be delayed or interrupted.

The provider is responsible for clinical decisions and billing. An authorization is not a guarantee of payment for services rendered. 

Recent Announcements

Community Care Behavioral Health is excited to announce this free upcoming web-based training opportunity:

A growing body of U.S. and international research demonstrates that the rapid legalization and commercialization of gambling—including online casinos and mobile sports betting platforms—are associated with significant and escalating gambling related harm. Although Pennsylvania specific prevalence data remain limited, available evidence is increasingly concerning, with gambling disorder linked to alarmingly high rates of suicide, psychiatric comorbidity, and social and financial harm. Drawing on lessons from the tobacco and opioid crises, this presentation will examine how delayed recognition and regulation can amplify population level harm, underscoring the need for earlier screening, prevention, and policy engagement. Participants will gain practical guidance on identifying patients at elevated risk, implementing evidence informed screening and diagnostic strategies, and applying current treatment approaches across the lifespan.
May 2026Education/Webinars

Bridging Smiles and Systems: Collaborative Care for Children with Chronic Conditions

Please join us for a live, CME-accredited and CEU-accredited webinar on May 13 from noon to 1p.m., that will explore the critical connection between oral health and pediatric chronic conditions such as diabetes, asthma, congenital heart disease, and ADHD.
Apr. 2026Education/Webinars

Certified Community Health Worker (CCHW) Provider Billing Notification

UPMC for You will now reimburse for up to three certified community health worker (CCHW) visits per member per calendar year for Medicaid recipients, per the Pennsylvania Department of Human Services (PA DHS).
Apr. 2026Important Notices