Featured Announcements
Important updates on influenza prevention and treatment
As we continue to navigate flu season, we want to emphasize three critical areas to ensure the health and safety of your patients who are UPMC Health Plan members: Consider antiviral therapy when appropriate, encourage masking to prevent the spread of respiratory viruses, and continue to recommend the flu vaccine.Recent Announcements
CME Webinar: Essential Best Practices for Newborn Care: Ensuring Healthy Beginnings Through Comprehensive Care
Please join us for a live, CME-accredited webinar on Wednesday, May 7, from noon to 1 p.m. that will provide an overview of newborn care.2025 Preventative Care Rewards Program
We’re excited to continue our preventive care rewards program in 2025. This program allows eligible UPMC for Life patients to earn rewards when they complete certain preventive services, such as an annual wellness visit, a breast cancer screening, a colorectal cancer screening, or a diabetic retinal eye exam (for members with diabetes only).Provider OnLine Enhancements
Provider OnLine will soon be launching enhancements to the authorization process.CME Webinar: Asthma Clinical Guideline Updates
Please join us for a live, CME-accredited webinar on Wednesday, April 30, that will provide an overview of asthma clinical guideline updates.HIPAA Fax Line Permanently Closed as of 2/1/2025
The UPMC Health Plan HIPAA Fax Line 412-454-7829 has been permanently closed and is no longer receiving faxes. The most efficient way to submit a PRD (Personal Representative Designation) form is for the member to do so via the Member Site (Digital Account).ACA Risk Adjustment Claims Submission Announcement
UPMC Health Plan would like to remind all network providers to submit all outstanding CY 2024 claims for ACA members (Platinum, Gold, Silver, and Bronze plans), no later than April 1, 2025.Oral Health in Your Pediatric Office
Please join us for a live, CME-accredited webinar on Wednesday, March 12, from noon to 1 p.m. that will provide an overview of oral health in your pediatric office. Providers with a(n) MD/DO, PA, CRNP, RN, LPN may also apply for topical fluoride certification after completion of this course.Building Trust: Person-Centered Strategies for Effective Decision Making and Preventive Care
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.
Artificial Intelligence for Medical Professionals – What You Need to Know
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.
Xylazine-Associated Wounds: Considerations for Antimicrobial Stewardship and Wound Care
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.
An updated version of the Notice of Medicare Non-Coverage (NOMNC) is available as of Jan. 9, 2025
If you have printed copies of the NOMNC form, please discontinue using them after Jan. 9, and replace them with the most current version. An updated form is now available on our website at the link below.Voluntary nationwide recall: Systane (Alcon – December)
Alcon Laboratories is recalling one lot, lot 10101, of Systane Lubricant Eye Drops Ultra PF, Single Vials On-the-Go. Systane Lubricant Eye Drops. Ultra PF is used for the temporary relief of burning and irritation in persons with dry eye symptoms.Voluntary nationwide recall: Prograf and Astagraf (Astellas – December)
Astellas Pharma US, Inc. is recalling one lot of Prograf, lot 0E3353D, and one lot of Astagraf XL, lot 0R3092A. Prograf and Astagraf XL are used in conjunction with other medicines to help prevent organ transplant rejection.Coming soon: Formulary updates effective Jan. 1, 2025
Please review updated information for the prescription drugs covered under each plan.
UPMC Health Plan Commercial plans
- View Advantage Choice formulary updates: upmchp.us/acformularychanges
- View Your Choice formulary updates: upmchp.us/ycformularychanges
- Policies can be found here: upmchealthplan.com/providers/medical/resources/manuals/policies-procedures.aspx
UPMC Health Plan medical drug coverage updates
UPMC Health Plan initiated changes to certain medical drug coverage policies for all lines of business on Jan. 1, 2025. Please visit upmchp.us/pharm-services-medical for more information. If you have questions about the changes, call Provider Services at 1-866-918-1595. Thank you for your continued support and for the great care you provide our members.