University of Minnesota
Office of Human Resources

Medication Therapy Management (MTM) Provider Information

The University of Minnesota Health Plan (UPlan) invites pharmacists to join the UPlan MTM Provider Network, to provide MTM services to eligible University employees and their dependents across Minnesota.

MTM providers are especially needed near the University campuses in Minneapolis, St. Paul, Duluth, Rochester, Crookston, and Morris, as well as regional extension offices and research and outreach centers throughout the state.

Pharmacist Eligibility

Pharmacists are eligible to become MTM providers in the UPlan network if they graduated during or after 1996, or have completed an approved continuing education course. An application form is available in the "For More Information" section below.

UPlan Member Eligibility

UPlan members are eligible to participate in MTM services if they are currently taking four or more UPlan-covered prescription and over-the-counter medications for chronic conditions or are referred by their physician. A referral request form is available in the "For More Information" section below.

UPlan members who participate in the MTM program have the opportunity to earn points in the UPlan's Wellness Program.  These points can be used toward a reduction on annual medical premiums. 

Note: There is no longer an enrollment form for UPlan MTM. To accumulate points toward a reduction in health care premiers, the employee must enroll in the   UPlan's Wellness Program at

UPlan Formulary

Prime Therapeutics LLC is the Pharmacy Benefit Manager for UPlan prescription claims. Pharmacists enrolled as providers in the UPlan MTM Network should consult the UPlan drug formulary when making recommendations for changes in a patient's medication therapy. The current University of Minnesota UPlan Formulary  lists the medications that are covered by the program.  

UPlan Prior Authorization (PA), Step Therapy (ST) and Affordable Care Act (ACA) information

For More Information

General Information about the UPlan MTM Provider Network

Application to Join the UPlan MTM Provider Network

Forms for Pharmacist MTM Providers

In the News

"Minnesota Pharmacists Getting Trained for More Face to Face Interaction"


State Employee Group Insurance Plan (SEGIP) MTM Diabetes Program

As of June 1, 2013, the UPlan MTM Network is providing MTM services for the State of Minnesota Employees with diabetes. Eligible employees will receive invitations by State of Minnesota and trained MTM pharmacists will provide MTM services to state employees who are enrolled in the program.

SEGIP Program Letter to Pharmacists
SEGIP Program Description for Pharmacists

SEGIP MTM Diabetes Management Program Forms and Documents

SEGIP Member Participation Agreement
SEGIP Medication Record Form
SEGIP Health Screening Form
SEGIP Key Contact Information

SEGIP D5 Data Submission

SEGIP D5 Letter
Data File Instructions-EMR

Data File Instructions-Excel

SEGIP Member Information

SEGIP Invitation to Enroll

Link to State web site for SEGIP MTM Diabetes Program

Program Comparison

UPlan MTM/SEGIP Program Comparison

Program Contact

Julie Balthazor
UPlan MTM Benefit Program
7-158 WDH
308 Harvard Street S.E.
Minneapolis, MN 55455