Medication Therapy Management Program
Absolute Total Care has programs that help members manage their Part D medications in special situations. For example, some members have several complex medical conditions at one time. These members may need to take many drugs at the same time or they could have high drug costs. A team of pharmacists and doctors created a program for us to help these members with their care. The program is called the Medication Therapy Management Program or MTMP.
The MTMP can help make sure that our members are using the drugs that work best to treat their medical conditions. The MTMP also helps us identify possible medication errors and helps improve their steady use of the drug. The program is not a benefit and is voluntary and free to eligible members.
Members who can join the MTMP:
- Have three or more of the following chronic disease states:
- Chronic Obstructive Pulmonary Disease (COPD)
- Hypertension or high blood pressure
- Dyslipidemia or high cholesterol
- End-stage renal disease (ESRD)
- Mental health - depression
- Have eight or more chronic or maintenance Part D medications.
- Most likely have higher drug costs (more than $3,967 each year).
If you meet the criteria for the MTMP, we will enroll you in the program. An MTM pharmacist will review your medication and we will send you a letter telling you that you qualify for the program. We will also inform you of any issues that were identified by the pharmacist. You should expect a call to schedule your medication review. You can also call us to ask for a medication review. If you do not want to be in the MTMP, please tell us and we will withdraw you from the program.
We will provide the following MTMP services with a final goal of helping the member meet the best health results:
- We will do a yearly Comprehensive Medication Review (CMR) either by phone or in-person to gather a list of all the member’s drugs and speak to the member about any concerns. This will take about 45 minutes.
- A Personal Medication List (PML) to record all prescription and over-the-counter medications which can be updated as needed (sample PML - PDF).
- A Medication Action Plan (MAP) made specific for the member after meeting with them to help them follow steps while taking medications to reach their health goals.
- The PML and MAP are printed and either hand-delivered or mailed within 14 calendar days of the CMR.
- Quarterly Targeted Medication Reviews (TMR), which identify potential safety concerns. Safety concerns may be drugs which are not recommended for those over age 65 or drug therapies that the member should be on based on their conditions. The member may receive a letter asking them to follow up with their doctor. Follow-up phone or fax communication may be made to the provider.
If the member is unable to participate, an authorized representative may participate on the member’s behalf. In addition, the pharmacist or pharmacy intern supervised by a pharmacist may work with other clinical team members if more services are needed in order to help the member reach their health goals.
For more information, please call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.
Member Services is ready to answer questions about the MTMP.
Last Updated: 03/01/2018
Our plan has programs that help you manage your Part D medications in special situations. You may have several complex medical conditions. If so, you may need to take many prescription drugs to treat those conditions. You also could have high drug costs.
A team of pharmacists and doctors created a program to help members like you with your healthcare. This is called the Medication Therapy Management Program, or MTMP. Our MTMP pharmacists help our members and their doctors choose the drugs that work best to treat their conditions. They also help find possible errors and improve drug adherence.
The program is not a benefit. The service is voluntary and at no cost to eligible members who:
- Have three or more of these conditions:
- Chronic Obstructive Pulmonary Disease (COPD)
- End-Stage Renal Disease (ESRD)
- High cholesterol (hyperlipidemia)
- Take eight or more chronic or maintenance Part D medications
- Spend more than $4,044 each year on drugs
If you meet the above list, we enroll you in our program. From there, one of our MTMP pharmacists reviews your drug history and sends you a welcome letter. The letter tells you about any potential drug problems found and invites you to call for a full review. If you don’t want to continue, just tell us. We will remove you from the program.
If you want to continue, one of our pharmacists or pharmacy interns, under the direct supervision of a pharmacist, will connect you with the following services. The goal is to help you reach the best results to fit your needs:
- Annual Comprehensive Medication Review (CMR). Done by phone or face-to-face, a CMR creates a collection of all of your medication-related information. The pharmacist will go over your drugs and health conditions. The CMR takes about 45 minutes. You can talk about any of your concerns.
- Personal Medication List (PML). A list of all your prescriptions and over-the-counter drugs will be reviewed. The PML can be updated as needed. Sample PML (PDF)
- Medication Action Plan (MAP). Our MTMP pharmacist creates your MAP. It helps you follow steps in taking medications to reach your health goals.
- We print your PML and MAP and either mail or hand-deliver them to you within 14 days of your CMR.
- Quarterly Targeted Medication Reviews (TMR). This review helps find possible safety concerns. They include drugs that people over age 65 should not take. The TMR also may offer other drug therapies that you should be for on your conditions but aren’t. If our MTMP pharmacists find issues, we send you a letter with ways to help improve your drug use. We may also fax any issues to your doctor.
If you want to be in our MTMP but are unable to, you can authorize someone on your behalf. Our MTMP pharmacist may work with other team members if you need more help or services.
If you have questions about the MTMP, contact Member Services. We are here to help.
Last updated: 11/29/2018