MEDICARE PART D and MTM
For Medicare Part D patients on high-cost medications or with certain health conditions, a pharmacist may provide (and get reimbursed for) medication therapy management (MTM) or an annual in-depth review of the patient’s medication profile. You may also hear it referred to as medication management therapy services (MMTS). The purpose of this review is to add a safety feature to prevent adverse reactions and drug interactions and to look at ways to reduce the patient (and insurance) cost.
MTM is a patient-focused, multi-step process where a pharmacist may meet with a patient and his or her primary healthcare provider, such as a physician, nurse practitioner, or physician assistant, to recommend adjustments to the patient’s medication therapy for better results.
These adjustments may include the use of less expensive medications, the identification of potential medication interactions or adverse reactions, counseling on the best use of medications and durable medical equipment, counseling on complying with the medication regimen, and providing helpful information regarding disease-state management.
Because this process is increasingly important to the long-term health of patients, a pharmacist may receive additional reimbursement from pharmacy benefit managers and other insurance companies for providing these specialized services.
As a technician, it’s important for you to understand this program so that you can better know how you might help your pharmacist as he/she carries out these duties. Here are some particularly helpful websites you might want to visit to learn more:
Medication Management Therapy Management Services
What is Medication Therapy Management?
Requirements for Medication Therapy Management Programs (MTMP)