Medication Therapy Management Program
Better therapeutic outcomes for members with multiple conditions
Our Medication Therapy Management Program (MTMP) is focused on improving therapeutic outcomes for Medicare Part D members. To qualify for MTMP, a member must meet all of the following criteria:
- Members must have filled eight or more chronic Part D medications; and
- Members must have at least three of the following chronic conditions - Alzheimer's Disease; Chronic Heart Failure (CHF); Diabetes; Dyslipidemia; End-Stage Renal Disease (ESRD); Hypertension; Respiratory Disease (such as Asthma, Chronic Obstructive Pulmonary Disease (COPD), or Chronic Lung Disorders); Bone Disease-Arthritis (such as Osteoporosis, Osteoarthritis, or Rheumatoid Arthritis); Mental Health (such as Depression, Schizophrenia, Bipolar Disorder, or Chronic/Disabling Mental Health Conditions); and
- Members must have incurred cost for all covered Part D medications greater than or equal to one-fourth of $4,696 in the previous three months.
The success of our MTMP is built upon our proven experience using a wide range of services designed to help members with multiple conditions by:
- Ensuring they take their medications correctly
- Improving medication adherence
- Detecting potentially harmful medication uses or combinations of medications
- Educating members and health care providers
Our programs are evidence-based and can integrate both pharmacy and medical data, when available, and are built upon multiple measures that demonstrate positive clinical outcomes for members like you. Pharmacists, physicians and PhDs develop, manage and evaluate the programs for effectiveness.
One-on-one consultations between our clinicians and members are also an important part of our MTMP. Such consultations ensure that members are taking their medications as prescribed by their health care provider.
Comprehensive Medication Review (CMR)
The Centers for Medicare & Medicaid Services (CMS) requires all Part D sponsors to offer an interactive, person-to-person comprehensive medication review (CMR) to all MTM-eligible members as part of MTMP. If you meet the criteria outlined above, you will receive an MTMP Enrollment Mailer or phone call offering our CMR services. A CMR is a review of a member’s medications (including prescription, over-the-counter (OTC), herbal therapies and dietary supplements), which is intended to aid in assessing medication therapy as well as optimizing outcomes. Also, MTMP-eligible members will be included in quarterly targeted medication review (TMR) programs that assess medication profiles for duplicate therapy or drug-disease interaction in which members’ prescribers may receive a member-specific report.
The CMR includes three components:
- Review of medications to assess medication use and identify medication-related problems. This may be conducted person-to-person or "behind the scenes" by a qualified provider and/or using computerized, clinical algorithms.
- An interactive, person-to-person consultation performed by a qualified provider at least annually to all MTM-eligible members.
- An individualized, written summary of the consultation for the member, including but not limited to, a personal medication list (PML), reconciled medication list, action plan, and recommendations for monitoring, education, or self-management.
View or download a sample copy of our MTMP Enrollment Mailer
View or download a copy of the medication action plan (MAP).
View or download a copy of the PML.
View or download a copy of your Member Rights and Responsibilities.
Contact MedImpact or your health plan at the number listed on the back of your ID card for general information about our MTMP. If you have specific questions about the MTM program, you can get more information at 1-844-866-3735. (TTY users dial 1-800-367-8939), Monday - Friday, 10 am to 8 pm Eastern.
These programs are provided at no additional cost as part of your coverage and are not considered a benefit.