Under state law, UMP (both UMP Classic and UMP CDHP) must follow 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 64 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. Please note that these decisions may be made and take effect at any time during the plan year. You may view final decisions and ongoing reviews at the HTCC website.
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.