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Board adopts medical pharmacy coupon program, removes several prior authorizations and expands diagnostic coverage
Summary
The board approved a voluntary UMR medical‑pharmacy coupon program (shared savings model) and agreed to remove prior authorization for biopsies, MRIs and dialysis. It also approved covering diagnostic breast imaging and colonoscopy at the preventive benefit level (CDHP deductible exception) and adopted a first‑annual nonnetwork lab education/payment exception.
The Public Employees Benefits Program board approved several vendor‑proposed operational and benefit changes intended to reduce member cost exposure and administrative burdens.
Coupon program: Siegel consultants and UMR described a voluntary medical‑pharmacy coupon program that applies manufacturer coupons to eligible medical‑benefit drugs. Richard Ward summarized earlier analysis: "The annual plan impact is about 1,100,000," and, after a UMR administrative share (25%), the net…
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