Medication Therapy Management

Summary of Services:

• Interactive comprehensive medication review (CMR)
• Annual Interactive, in-person or synchronous telehealth consultation
• Targeted medication reviews, at least quarterly, with follow-up interventions when  necessary
• Information on the safe disposal of prescription drugs that are controlled substances Method(s) of delivery for the safe disposal information
• Welcome letter/MTM program enrollment package

Targeted beneficiaries for the MTM program are enrollees who meet the characteristics of at least one of the following two groups:

1. Meet all of the following three criteria:
   • Have at least 3 (three) of the below mentioned chronic diseases/conditions:
     • Alzheimer’s Disease
     • Bone-disease arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis
     • Chronic congestive heart failure (CHF)
     • Diabetes
     • Dyslipidemia
     • End-stage renal disease (ESRD)
     • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
     • Hypertension
     • Mental health (including depression, schizophrenia, bipolar disorder, and chronic/disabling mental health conditions)
     • Respiratory diseases such as asthma, chronic lung disorders, or chronic obstructive pulmonary disease (COPD).
   • Take eight or more Part D (prescription) medications.
   • Have or will likely have $1,623 or more in total costs for Part D (prescription) medications in 2025.
2. Are identified as at-risk beneficiaries (ARBs) in the Drug Management Program.

Comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs):

• We will automatically enroll MTM eligible members, including those in long term care (LTC) settings, into the MTM program once they meet qualification criteria. The vendor also sends a welcome letter within 60 days that provides an explanation of the program, provides instructions to opt out, offers the opportunity to request or schedule a Comprehensive Medication Review (CMR), and includes information on the safe disposal of prescription drugs that are controlled substances. The member may request a CMR by calling the provided toll-free number or scheduling a telephone or video telehealth appointment with a qualified MTM provider through an online scheduling portal.
• Targeted Medication Reviews (TMRs) will be completed on at least a quarterly basis for all qualified members unless they opt out of the program. At the end of each quarter, all qualified members are reviewed to ensure that a TMR has been performed during that quarter. TMRs take about 30 minutes —if you qualify. The review timeframe may be slightly longer if you have a lot of medications. TMRs identify opportunities for intervening on drug therapy problems that may be related to appropriateness, effectiveness, safety, and adherence. We may contact the member or their prescriber via telephone, postal mail, or electronic fax for a review of these drug therapy problems. Follow up interventions may be performed when appropriate. TMR opportunities that result in live outreach may allow for an additional opportunity to offer a CMR. Interventions from CMRs and TMRs may result in prescriber outreach via telephone, fax, or direct secure messaging via the electronic health record (EHR) when appropriate.

For more information about the MTM program, call member services at 1-888-477-0090 (TTY: 711).

Hours of Operation: 8am - 8pm, 7 days* a week
*October 1st - March 31st / Mon- Fri rest of the year

Once you are selected for the MTM Program, you will receive an eligibility notification letter and will be contacted to schedule a telephone consultation with a pharmacist. They will review your current prescriptions and over-the-counter medications and conduct an ongoing comprehensive medication review (CMR) to identify any potential medication related issues. If any medication issue is identified during the telephone consultation with a pharmacist, we will discuss it with your provider. Through this review, the pharmacist is able to identify and reduce the chance for medication errors; they will have more information about your current medication therapy, can help reduce duplicative therapy and offer affordable formulary alternative if applicable and it’s a great opportunity to identify and educate you on the side effects of the drugs you are taking and discuss ways to reduce those effects.

Upon completion of the CMR, an individualized written summary in the CMS standard format will be provided to you within 14 days of the CMR. The summary has a medication action plan that recommends what you can do to make the best use of your medications, with space for you to take notes or write down any follow-up questions. You will also get a personal medication list that will include all the medications you are taking and why you take them.

Download a blank copy of the Personal Medication List (pdf).

All MTM participants will receive follow-up mailings on a quarterly basis to remind them of their opportunity for the CMR and to provide general member education materials.

Participation in this program is voluntary. You are not required to participate in this program if you do not wish to do so. You can contact Med Impact at 1-833-459-4424 (TTY: 711), 24 hours a day, 7 days a week to opt-out.

Last Updated on April 17, 2025