OBJECTIVES:  To gain a better understanding of health-plan management of specialty pharmacy (SP), SP-products (2015 spending increased 21.5%) and diagnostic/genetic testing (per-test costs declining,availability/use increasing). METHODS:  Online survey of US medical+pharmacy directors from public/private plans with multiple member-types on: advisor+plan information; specialty-pharmacies/pharmaceuticals, copays, and genetic/diagnostic test coverage and restrictions. RESULTS: MDs represented 59% of respondents from plans representing commercial lives=79.6%; Medicaid (low-income)=61.1%; Medicare (elderly)=68.5% with 28.6%=local; 41.1%=National; and 30.4%=regional. SPs were a top current/future concern. 51.7% of plans restricted SP providers and 40.3% used their PBM as their SP, 46.1% of the SPs were privately-owned, 46.1% PBM-owned, and 7.7% hospital-IDN-owned. Top SP-conditions included HCV=90.4%;Oncology=88.5%;HIV=73.1%. The majority (68.1%) restricted SP services to a small set under contract, 14.9% allow any SP; 14.9% only restricted products available through multiple specialty-pharmacies, 2.1% carved them out. Plans covered clinician-administered products (CAPs, i.e., injections/infusions) under the medical-benefit (MB= 64.3%); under the pharmacy-benefit (PB=5.4%); 30.4% were product-specific; 70.9% expect no change; and 29.1% expect to complete changes before 12-2018. Oral Biologics (OBs) were managed under the PB=78.9%; the MB=7.0%; 14.0% based on plan-design/product. Expectations for OB benefits: no change (78.6% of plans), currently changing (7.1%); before 12-2017 (12.5%) and before 12-2019 (1.8%). SP+OB copays vary by group/benefit design and are shifting from fixed to %-copays with Multiple-Sclerosis agents maintaining more fixed copays. Most (82.5%) of plans do not require AMCP-dossiers for testing. In 2016, genetic tests (GTs) were covered in all cases (63.5% of plans); not covered (15.4%) and threshold-based (21.1%) with minimal expected changes. GT coverage was highest for oncology (92.4%); OB/GYN (66.0%); cardiovascular (52.8%). Disease marker tests were covered in all cases (79.6%), not covered (5.6%), and 14.8% threshold-based. Coverage for therapy-response tests (HCV, RA, etc): all cases (68.5%), no-cases (20.4%); and 11.1% threshold-based. CONCLUSIONS: Testing and specialty pharmacy/pharmaceutical expenditures are expected to grow and require appropriate coverage.