CommercialAdministrativeMedium impact
Requirements under the No Surprises Act
UPMC Health Plan·Reimbursement
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
The No Surprises Act requires providers to keep directory information current with UPMC Health Plan by notifying them of network terminations, material changes, and responding to verification requests. LexisNexis will contact providers quarterly to verify information, and incentive payment eligibility depends on completing this verification process.
Action Required
Quarterly: Respond to LexisNexis verification requests via phone, fax, or online when contacted each quarter. Immediately: Notify UPMC Health Plan when terminating network agreements or when material changes occur to provider directory information. Update information at upmchealthplan.com/providers/change.html or through Provider OnLine reports. Failure to complete quarterly verification will result in loss of incentive payment eligibility.