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A someone is going to take the time to choose a plan that is both equally suited and very affordable. UMR's Utilization Management program is URAC. Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. Clinical Practice Guidelines for Texas Commercial, Marketplace, Medicare and Medicaid plans. Medical Policy Criteria and Guidelines Medical Policy Criteria and Guidelines PA/MND Process PA/MND Process Using Out-of-Network Providers in Surgical Services Using Out-of-Network Providers in Surgical Services. Healthcare and health insurance information. Open enrollment period. 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