Please join us for a live, CME-accredited webinar on Wednesday, March 26, from noon to 1 p.m. that will provide an overview of artificial intelligence for medical professionals.

Towa Pharmaceutical is recalling one lot, lot 220128, of Duloxetine Delayed-Release Capsules, USP, 20 mg. Duloxetine is used to treat anxiety, depression, and certain types of nerve pain.

Endo USA Inc. has recalled certain lots of Clonazepam Orally Disintegrating Tablets, USP (C-IV). This is an expansion of a previous recall by Endo. Clonazepam is used to treat panic disorder and certain seizures.

Please join us for a live, CME-accredited webinar on Tuesday, Feb. 25, from noon to 1 p.m. that will educate providers on the important topic of xylazine associated wounds.

Please join us for a live, CME-accredited webinar on Tuesday, Feb. 18, from noon to 1 p.m. that will review person-centered strategies for effective decision making and preventive care.

Please join us for a live, CME-accredited webinar on Tuesday, March 11, from noon to 1 p.m. that will review colorectal cancer screening.

On Nov. 8, 2024, the security settings for UPMC Health Plan’s Provider OnLine website will be updated.

We are always looking for ways to improve Provider Partner Update as a resource for you. Are you aware of the newsletter, and does it help you stay up to date on initiatives and programs?

By completing this brief survey, you can tell us what’s important to you in Provider Partner Update and how we can enhance your experience with it.

On Sept. 1, 2024, UPMC Health Plan reduced the frequency at which we process paper checks and electronic funds transfers (EFTs) each month. Please note that UPMC Health Plan will continue to process clean claims within the timeliness standards that are outlined in the provider agreement.

Pfizer Inc. is withdrawing Oxybryta from the market. Oxbryta is used for the treatment of sickle cell disease in adults and children 12 years old and older. Sickle cell disease affects the shape of red blood cells, which carry oxygen to all parts of the body.

Bionpharma Inc. is recalling one lot, lot 2310083, of Atovaquone Oral Suspension, 750 mg/mL. Atovaquone is used to prevent a fungal infection called pneumocystis jirovecii pneumonia in adults and adolescents age 13 and older.

Your Medicare patients with high drug costs may benefit from participating in the Medicare Prescription Payment Plan, which will be available beginning on Jan. 1, 2025.

Effective Oct. 1, 2024, UPMC Health Plan will be using a new vendor for the Quarterly Attestation process form. All attestations must be through Council for Affordable Quality Healthcare (CAQH). Please note this does not apply to Premier Partner offices.

We previously communicated to both contracted physicians and facilities that UPMC Health Plan will begin applying Multiple Procedure Payment Reduction (MPPR) on certain diagnostic imaging services for Commercial, Medicare and Medicaid lines of business, with contracts based on a percentage of Medicare APC or % billed charges excluded.

The Pennsylvania Department of Health (PA DOH) and Philadelphia Department of Public Health (PDPH), in collaboration with the Center for Forensic Science Research & Education (CSFRE), are providing virtual trainings to clinicians and non-clinicians on best practices for caring for individuals with xylazine-associated wounds. These trainings are offered at no-cost to attendees.

Improving antibiotic prescribing is a priority as antibiotics are still widely overprescribed for conditions where they are not indicated. Beginning or building an antibiotic stewardship program is an effective way to improve health outcomes and reduce costs related to antibiotic resistance. Providers can embrace antibiotic stewardship efforts using these and other best practices:

Improving antibiotic prescribing is a priority as antibiotics are still widely overprescribed for conditions where they are not indicated. Beginning or building an antibiotic stewardship program is an effective way to improve health outcomes and reduce costs related to antibiotic resistance. Providers can embrace antibiotic stewardship efforts using these and other best practices:

As previously communicated, UPMC Health Plan will retire Appendix A – COVID-19 Special Coverage and Payment Policy for all lines of business on Sept. 30, 2024. However, UPMC Health Plan will extend the $0 cost share until Dec. 31 for the following services for UPMC for You members when the services are clinically indicated and consistent with generally accepted practice guidelines based on an individual assessment by the member’s attending provider:

Abbott has announced a medical device correction for three lots of FreeStyle Libre 3 sensors, distributed in the United States during the first half of May 2024. The FreeStyle Libre 3 reader and app are not affected. FreeStyle Libre 3 sensors are used to monitor blood glucose levels as part of the FreeStyle Libre system. The FreeStyle Libre 3 system includes a sensor, reader and app. This medical device correction impacts the sensor only.

Caring for your patients’ mental health needs is essential to their overall well-being. You can use these and other processes and resources to support their behavioral health needs.

September is National Recovery Month, and you are invited to watch a timely, CME-accredited webinar series on the topic. Michael Lynch, MD, FACMT, UPMC Health Plan Quality and Substance Use Disorder Services Medical Director; Associate Professor of Emergency Medicine and Medical Toxicology University of Pittsburgh School of Medicine, leads this four-part series. Watch these recorded webinars to build your knowledge base:

Endo USA Inc. has recalled one lot of Clonazepam Orally Disintegrating Tablets, USP (C-IV) 0.25 mg. Clonazepam is used to treat panic disorder and certain seizures.

This product is being recalled because the cartons of some packs show the product strength as 0.125 mg, not 0.25 mg, due to an error at a third-party packager. The blister strips inside the product pack reflect the correct strength of 0.25 mg.

As your partner in care, we wanted to share information regarding the annual conference of the Camden Coalition’s National Center for Complex Health and Social Needs, Putting Care at the Center, which gathers healthcare and social service providers, policymakers, advocates, program leaders, payers, researchers, and more.

Please make time to review this on-demand, continuing medical education (CME)-accredited webinar on heart failure. During this presentation, Jennifer Kliner, CRNP:

Please join us for a live, CME-accredited webinar on Wednesday, Oct. 30, from noon to 1 p.m. that will review targeted optimal pharmacotherapy in patients with heart failure.

BluePoint Laboratories is recalling 21 batches of Potassium Chloride Extended-Release Capsules, USP (750 mg) 10 mEq K. Potassium Chloride is used for the treatment of low potassium.

In 2023, 96 percent of physician practice survey respondents indicated they would recommend UPMC Health Plan to other physician practices. In addition, respondents ranked UPMC Health Plan in the 95th percentile when comparing UPMC Health Plan to other Health Plans with whom they participate.

As all Special Coverage and Payment Policies related to the COVID-19 public health emergency have expired or will expire effective Sept. 30, 2024, as indicated in Appendix A, UPMC Health Plan will retire Appendix A – COVID-19 Special Coverage and Payment Policy for all lines of business on Sept. 30, 2024. To review our policies and procedures manual, please visit upmchp.us/policiesandprocedures.

Please join UPMC Health Plan’s Risk Adjustment/HCC Coding Education Program Director Marlana Tice for a live, continuing medical education (CME)-accredited webinar on Thursday, Sept. 26, from noon to 1 p.m., that will deliver an overview on provider diagnosis documentation improvement.

In 2023, 96 percent of physician practice survey respondents indicated they would recommend UPMC Health Plan to other physician practices. In addition, respondents ranked UPMC Health Plan in the 95th percentile when comparing UPMC Health Plan to other Health Plans with whom they participate.

Glenmark Pharmaceuticals Inc. is recalling 114 batches of Potassium Chloride Extended-Release Capsules, USP (750 mg) 10 mEq K. Potassium Chloride is used for the treatment of low potassium.

On June 13, 2024, UPMC’s Provider OnLine migration took place to update our user access security structure. If you are a user of Provider OnLine but had not logged on in the last 150 days before June 13, you may need to take a security step to re-register.

Providers can now use the two addiction medicine eConsult services in Epic for support when patients present with substance use issues. The eConsults allow providers to communicate with general internal medicine and ob-gyn physician groups specializing in addiction to get recommendations.

Please join us for a live, CME-accredited webinar Wednesday, Aug. 14 from noon to 1 p.m. that will provide an overview on addressing adolescent health needs. This webinar is being offered as part of the UPMC Health Plan Pediatric Collaborative Call series.

Dr. Reddys Laboratories Ltd. has recalled six lots of Sapropterin Dihydrochloride Powder for Oral Solution 100 mg. Sapropterin is used to reduce blood levels of a certain amino acid in people with a rare, inherited disorder called phenylketonuria.

UPMC Health Plan has discovered an issue with some of the Electronic Remittance Advice (835) data that was sent to providers. The issue—which is related to a systems enhancement—exists only within the 835 data. No issues have been found on Explanations of Payment or Explanations of Benefits.

This month, we are highlighting several educational opportunities featuring such topics as pediatric behavioral health conditions and suicide and depression screening and assessment. These trainings offer clinicians the opportunity to learn more about evidence-based practices and tools for encouraging patients to receive screening, assessment, treatment and/or referral, as well as ongoing care and monitoring for behavioral health conditions.

UPMC for Life Medicare Advantage credentialed providers may use the UPMC Health Plan Self-Registration Transparency Tool for additional information.

At UPMC Health Plan, we value our relationships with our network providers and appreciate the excellent care you give to our members. As part of a world-class health care delivery system, we strive to improve our processes where applicable and promote and reflect efficient and current health care practices.

Effective Sunday, May 5, 2024, the UPMC Health Plan UM department staff and UM phone lines will no longer be available on Sundays. The UM department will be operating during the business days of Monday through Saturday from 8 a.m. to 4:30 p.m.