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The Buzz About Medication Therapy Management Services

Fred M. Eckel, RPh, MS
Published Online: Saturday, January 1, 2005   [ Request Print ]

Well, get ready for some new acronyms to add to your pharmacy vocabulary, MTMS and MMA. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, commonly referred to as MMA (Medicare Modernization Act), includes a section on Medication Therapy Management Services (MTMS). Although not limited to pharmacists, the description of MTMS states that "drug therapy management?may be furnished by a pharmacist."No other professional is mentioned as a provider of MTMS. The MMA provides MTMS to Part D-eligible individuals who (1) have multiple chronic diseases, (2) are taking multiple drugs, and (3) are likely to incur expenses that exceed a level specified by the secretary of the Department of Health and Human Services.

An American Pharmacists Association monograph suggests, in part, that medication therapy monitoring programs could include the following:

    ?Managing and monitoring drug therapy in patients receiving treatment for cancer or chronic conditions such as asthma and diabetes ?Consulting with patients and their families on the proper use of medication ?Conducting wellness and diseaseprevention programs to improve public health ?Overseeing medication use in a variety of settings, such as home care settings, hospitals, ambulatory care settings, long-term care facilities, clinics, and intensive care units

Of course, numerous questions have been raised about how this service will work. Many of these questions will be answered when the Center for Medicare and Medicaid Services (CMS) releases its program rules in early 2005. To assist CMS in developing MTMS under Medicare Part D and to develop a unified perspective for MTMS within pharmacy, 11 national pharmacy organizations have approved MTMS Definition and Program Criteria (page 72). If CMS follows the profession's recommendation, pharmacists will have an opportunity to get paid for cognitive services offered to many Medicare patients with Part D coverage. Because Part D will be a voluntary program, patients will have to enroll in this program to be eligible.

The question some have is whether pharmacists will accept this opportunity to promote appropriate drug use. Previous efforts to provide clinical services by pharmacists for payment found fewer pharmacists than expected participating. Pharmacy Times believes that this program is important to Medicare patients and to pharmacists.

Therefore, this article is the first in an ongoing series that will cover all aspects of MTMS during 2005. We will include articles, commentaries, and news items to keep you informed and to help prepare you to provide MTMS. We want to help ensure that pharmacists do accept this opportunity to benefit selected Medicare patients.

Mr. Eckel is the editor-in-chief of Pharmacy Times.

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