ALERT! The HTCC reviews health technologies to determine whether services should be covered by state agencies or certain state-sponsored health plans such as UMP. (See the list of pending and final decisions on the HTCC website.) UMP will notify subscribers in writing if a coverage policy changes during the plan year based on an HTCC decision.
Under state law, UMP (both UMP Classic and UMP CDHP) follows coverage decisions made by the Washington State Health Technology Clinical Committee (HTCC). If the Committee has determined that a service or treatment is not covered, then the plan will not cover the service, even if your provider considers it medically necessary (see exclusion 65 on this list). If the Committee has determined that a service or treatment may be covered, then it will be covered only in cases where it meets the Committee’s specific coverage criteria. You may view final decisions and ongoing reviews at the HTCC website. Note that decisions made by the HTCC may also be called Health Technology Assessment (HTA) decisions.
If you have questions about services affected by HTCC decisions, call UMP Customer Service at 1-888-849-3681.
ALERT! If you receive services that are not covered under an HTCC decision, but would be under standard Regence coverage policy, the HTCC policy takes precedence. The plan does not cover the services, and you are responsible for all charges.