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.