Medication Therapy Management
2024 Medication Therapy Management
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 six 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:
- 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 medication list, reconciled medication list, and recommended to-do list for monitoring, education, or self-management.
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: https://www.dea.gov/takebackday.
- 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
2023 Medication Therapy Management
If you are in a Medicare drug plan and have complex health needs, you may be able to participate in a Medication Therapy Management (MTM) program. MTM is a service offered by Senior Care Plus at no additional cost to you! The MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is not considered a benefit. This program helps you and your doctor make sure your medications are working. It also helps us identify and reduce possible medication problems.
To take part in this program, you must meet certain criteria set forth in part by CMS. These criteria are used to identify people who have multiple chronic diseases and are at risk for medication-related problems. If you meet these criteria, we will send you a letter inviting you to participate in the program and information about the program, including how to access the program. Your participation in MTM is voluntary and does not affect Medicare coverage for drugs covered under Medicare.
To qualify for Senior Care Plus’s MTM program, you must meet ALL of the following criteria:
- Have at least 3 of the following conditions or diseases: Chronic Heart Failure (CHF), Diabetes, Dyslipidemia (High Cholesterol), Hypertension (High Blood Pressure), Asthma or Chronic Obstructive Pulmonary Disease (COPD) AND
- Take at least 8 covered Part D medications, AND
- Are likely to have covered Part D medication costs greater than $4,935 per year
To help reduce the risk of possible medication problems, the MTM program offers two types of clinical review of your medications:
- Targeted medication review: at least quarterly, we will review all your prescription medications and contact you, by phone or mail, and/or your doctor if we detect a potential problem.
- Comprehensive Medication Review (CMR): at least once a year, we offer a free discussion and review of all of your medications by a pharmacist or other health professional to help you use your medications safely. This review, or CMR, is provided to you confidentially via telephone by a clinical pharmacist directly employed by Senior Care Plus or by myMTMcare through their licensed pharmacists. These services are provided on behalf of Senior Care Plus. This review requires about 30 minutes of your time. Following the review, you will get a written summary of this call, which you can take with you when you talk with your doctors. This summary includes:
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
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 myMTMcare at 775-900-4775 from 7 a.m. to 8 p.m. PST Monday–Friday. TTY users should call the State Relay Service Number at 711. This is not considered a benefit.
