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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
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.
The Complete UPlan MTM Benefit Program Design Statement (pdf)
Frequently Asked Questions (pdf)
UPlan MTM Policies and Procedures (Administrative Program) (pdf)
General Instructions for Submitting MTM Claims (pdf)
Key Contact Information for UPlan MTM Providers (pdf)
MTM Fee Structure (Excel)
UPlan MTM/SEGIP Program Comparison
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 http://www1.umn.edu/ohr/wellness/wellnesspointsbank/index.html
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.
Prior Authorization Program(pdf)
Step Therapy Program(pdf)
Prior Authorization and Step Therapy Criteria(pdf)
Prior Authorization Forms (choose "Get Forms")
ACA Preventive Medications(pdf)
ACA Contraceptive Medications(pdf)
As of June 1, 2013, the UPlan MTM Network is providing MTM services for 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.
MTM Benefit Program Coordinator
MTM Benefit Program Assistant
B288 Mayo Memorial Building
420 Delaware Street S.E.
Minneapolis, MN 55455
308 Harvard Street S.E.
Minneapolis, MN 55455