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, and to employees participating in the State of Minnesota SEGIP(State Employee Group Insurance Plan) Diabetes MTM Program.

MTM providers are needed throughout the State of Minnesota

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.

Application to Join the UPlan MTM Provider Network

  In the News

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

Information for Network Provider

  Our Program Comparison provides a summary of details and requirements for both of the programs served by our network: The University of Minnesota  
  UPlan MTM Programa & THe State of Minnesota SEGIP Diabates MTM Program

  UPlan MTM/SEGIP Program Comparison

University of Minnesota UPlan MTM Program
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 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

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 receive invitations  to enroll however, all SEGIP employees with a diagnosis of diabetes are eligible for the program and credentialed network pharmacists may enroll any employees who fits the criteria for participation. Currently, spouses and covered dependents are not eligible for this program. For more information on program eligibility see SEGIP FAQs. 

       SEGIP Program Letter to Pharmacists
       SEGIP Program Description for Pharmacists

  Links to State web site for SEGIP MTM Diabetes Program

   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 
              Date File Instructions-Excel

   SEGIP Member Information

              SEGIP Invitation to Enroll
              SEGIP FAQs

  Program Contact

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


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