Medicare AdvantageAdministrativeHigh impact
Provider Directory Updates and Required Attestation
UPMC Health Plan·Provider Announcement
We identified it
Aug 7, 2026
Summary
UPMC Health Plan requires all providers (except Premier Partners) to verify and attest their provider directory information every 90 days using the CAQH Provider Data Portal. This is a compliance requirement per CMS/DHS/PID regulations and the federal No Surprises Act. Failure to complete quarterly attestation may result in removal from the directory and further action per the provider agreement.
Action Required
ONGOING QUARTERLY REQUIREMENT: All providers must register with and use the CAQH Provider Data Portal (https://proview.caqh.org/) to verify and attest provider directory information every 90 days. Providers should immediately: (1) Register with CAQH if not already registered; (2) Review and update all required information including: ability to accept new patients, street address, phone number, office hours, hospital privileges, telehealth availability, and any other information affecting member access; (3) Verify information appears correctly in the UPMC Health Plan online directory (upmchealthplan.com/find); (4) Make updates at upmchealthplan.com/providers/change-provider-profile-info.aspx; (5) Review NPI data in the National Plan & Provider Enumeration System (NPPES) to ensure accuracy. Billing team should set calendar reminders for 90-day attestation cycles and monitor for CAQH email/phone outreach alerts. Failure to attest every 90 days may result in removal from the directory, inability for members to schedule appointments, and potential payment suspension per the participating provider agreement.