What is a Medicare MTM program?

What is a Medicare MTM program?

Plans with Medicare drug coverage must offer free Medication Therapy Management (MTM) services if you meet certain requirements or are in a program to help members use their opioids safely. This program helps you and your doctor make sure that your medications are working to improve your health.

What is the main purpose of MTM?

The goal of MTM is to optimize the therapeutic outcomes of an individual patient as well as detect and prevent costly medication related adverse events.

What is the name of the legislation that required MTM services to be a part of Medicare Part D?

The Patient Protection and Affordable Care Act (PL 111-148) authorized grants for “medication management services” in all practice settings (Section 3503), noting that such services will help manage chronic disease, reduce medical errors, and improve patient adherence to therapies while reducing acute-care costs and …

How does one qualify for MTM?

Who is eligible to participate in the MTM Program?

  • Have three (3) or more chronic diseases (such as osteoporosis, rheumatoid arthritis, congestive heart failure, diabetes, dyslipidemia, asthma, COPD, and hypertension);
  • Use five (5) or more Medicare Part D drugs related to chronic conditions;

Who benefits from MTM?

People who may benefit the most include those who use several medications, those who have several health conditions, those who have questions or problems with their medications, those who are taking medications that require close monitoring, those who have been hospitalized, and those who obtain their medications from …

What are the two critical aspects of MTM services?

Medication management, also called medication therapy management (MTM), is a patient-centered process to create treatment plans centered on each patient’s medication-related goals. There are two distinct components to medication management: medication reconciliation and medication review.

What role and activities do pharmacy technicians have in MTM and CMM?

In the majority of pharmacy’s MTM programs, technicians are used to monitor third-party MTM databases. Technicians also monitor a patient’s adherence to their medication regimen, and alert the pharmacist if the patient is late on getting their medication refilled.

Which organization must review and approve MTM programs annually?

At the same time, CMS began requiring Part D plans to expand their current MTM programs to include an annual comprehensive review of medications, a process to assess the medication use of individuals who are at risk, and automatic enrollment of targeted beneficiaries who qualify on a quarterly basis.

Which individual S may provide MTM services based on federal law?

States the MTM are to be provided by a licensed pharmacist. Stipulates the MTM shall include the following pharmaceutical care services in order to optimize the therapeutic outcomes of the member’s medications: Performing or obtaining necessary assessments of the member’s health status.

In what ways can a pharmacy technician assist in the MTM process?

Pharmacy technicians assist in the MTM process by helping with research and counseling patients. When a patient and a pharmacist meet for a MTM review, they may discuss things such as less expensive alternatives, possible medication interactions, and complying with the medication regimen.

What is the Meaningful Use criteria?

The criteria for meaningful use are based on a series of specific objectives, each of which is tied to a measure that allows EPs and hospitals to demonstrate that they are meaningful users of certified EHR technology. For Stage 1, which begins in 2011, there will be 25 objectives/measures for EPs and 24 objectives/measures for eligible hospitals.

Will CMS’ final rule phase in more robust criteria for meaningful use?

To accomplish this, CMS’ final rule would phase in more robust criteria for demonstrating meaningful use in three stages.

How does a hospital demonstrate meaningful use of an EHR?

In 2012, EPs, eligible hospitals and CAHs seeking to demonstrate meaningful use must electronically submit clinical quality measures selected by CMS directly to CMS (or the States) through certified EHR technology. CMS recognizes that for clinical quality reporting to become routine, the administrative burden of reporting must be reduced.

What is a CMS-approved MTMP?

A CMS-approved MTMP is one of several required elements in the development of Sponsor’ bids for the upcoming contract year.