senior woman picking up her medication

Medication Therapy Management

Medication Therapy Management

Better Therapeutic Outcomes for Members with Multiple Conditions

2025

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 
    • Bone Disease Arthritis 
    • Congestive Heart Failure 
    • Diabetes 
    • Dyslipidemia 
    • End Stage Renal Disease 
    • HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) 
    • Hypertension 
    • Mental Health Disorders 
    • Respiratory Disease
  • Members must be likely to incur 2025 annual costs of $1,623 for all covered chronic Part D medications.

OR

  • Are in a Drug Management Program to help better manage and safely use medications such as opioids and benzodiazepines
 

2024

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
    • Asthma

    • Chronic Obstructive Pulmonary Disease (COPD)

    • Congestive Heart Failure (CHF)

    • Diabetes

    • High Blood Pressure

    • High Cholesterol

  • Members must be likely to incur 2024 annual costs of $5,330 for all covered chronic Part D medications.

OR

  • Are in a Drug Management Program to help better manage and safely use medications such as opioids and benzodiazepines

Do you meet all of the criteria above?

MTMP will help you learn about how to manage the various medications you need to stay healthy.

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 healthcare 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 healthcare 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:

  1. 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.
  2. An interactive, person-to-person consultation performed by a qualified provider at least annually to all MTM-eligible members.
  3. An individualized, written summary of the consultation for the member, including but not limited to, a medication list, reconciled medication list, and recommended to-do list for monitoring, education, or self-management.

Medication Action Plan (MAP): The action plan has steps you should take to help you get the best results from your medications.

Personal Medication List (PML): The medication list will help you keep track of your medications and how to use them the right way

Do you have unused expired medications and are looking for a safe way to dispose of them? Before you throw them away, here are some things you should know.

Here is how to safely dispose of unused or expired medications before they do harm:

For safety reasons, dispose of unused medications as soon as possible. Here are a few tips for safe disposal:

    • Find a nearby pharmacy or other local resource with a medication take back service.
    • The US Drug Enforcement Administration (DEA) allows unused prescription medications to be returned to pharmacies or other authorized sites. You can locate participating locations at: https://apps2.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e2s1.
    • Community take-back sites are the preferred method of disposing of unused controlled substances.

Additional drug disposal information can be found on the DEA website at:

If you cannot get to a drug take-back location promptly, or there is none near you:

  • Mix the unused supply with an undesirable substance such as dirt or coffee grounds.
  • Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag, then place the sealed container in your trash.
  • Make sure to conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off to protect your privacy.
  • Place both the sealed container with the mixture and the empty drug containers in the trash.
  • Only flush approved unused or expired medications down the toilet only if indicated on the label, patient information, or no other disposal options are available.

More information on the safe disposal of medications can be found on the United States Department of Health and Human Services website: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

If you take multiple medications for more than one chronic health condition, contact your drug plan to see if you are eligible for the MTM program. If you have any questions regarding the MTM program, please call at 775-799-7240 from 6 a.m. to 6 p.m. PST Monday–Friday. TTY users should call the State Relay Service Number at 711. This is not considered a benefit.