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Prohibiting Financial Incentives for Utilization Management

UPMC Health Plan Behavioral Health Services’ utilization management decision-making is based only on appropriateness of care and service and existence of coverage. UPMC Health Plan Behavioral Health Services does not specifically reward practitioners or other individuals for issuing denials of coverage, service or care and does not offer financial incentives for utilization management decision makers.

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H3907_H5533_H1254_08_417 (02/2008)