UPMC Health Plan – Community HealthChoices Contract with the Pennsylvania Department of Human Services – Performance Audit for the Period January 1, 2022 to December 31, 2022

The performance audit by the Department of the Auditor General assessed UPMC Health Plan’s (UPMC) Community HealthChoices (CHC) contract with Pennsylvania’s Department of Human Services (DHS) for 2022. The audit evaluated UPMC’s provision of accurate and timely participant eligibility information to DHS, crucial for setting accurate capitation rates. Two major findings resulted in 17 recommendations. The department announced this audit during a press conference on March 31, 2025. Read the press release from the announcement.