Affirmative Statement Regarding Incentives

Western Health Advantage reviews all decisions about the appropriateness of care and services, taking into consideration the individuals circumstances and plan benefits. Reviewers are never linked to any financial incentives or compensation to the person(s) conducting the review, and therefore do not encourage decisions that result in underutilization. If you would like to obtain copies of UM criteria currently used by WHA on a particular subject matter or desire a copy of WHA's pharmaceutical management procedures, please contact WHA at: (916) 563-3180.