UPMC Health Plan uses Interqual® criteria sets for prior authorizations

May 2024Education/Webinars

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


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