PART D PLANS SKIMPING ON MTM SERVICES, BRIEF CHARGES
The nation's pharmacistsare being frozenout of medication therapymanagement (MTM)by Part D drug plans thatare failing to providemeaningful MTM servicesto seniors, health careadvocates charged. Thoseallegations are a bitterpill for organized pharmacy,which fought forand won provisions in the new Medicare drug lawrequiring Part D drug plans to make MTM benefitsavailable to their members.
Despite that congressional mandate, however,a brief prepared by the Medicare RightsCenter maintains that the majority of Part Ddrug plans are not offering patients face-to-facemedication counseling and other MTM servicesby trained pharmacists. According to the advocacygroup, the Centers for Medicare &Medicaid Services (CMS) has given privateinsurers too much discretion in the design ofthe MTM services under Part D.
As a result, "the majority of popular plans areonly providing educational material by mail or overthe phone with in-house staff rather than face-tofaceinteraction with an independent pharmacistor care team," officials at the Medicare RightsCenter charged. "Few plans provide comprehensivemedical review or follow-up."
Under the law, MTM services must be designed"to optimize therapeutic outcomes throughimproved medication use and to reduce the risk ofadverse events" for private Medicare drug planmembers who have multiple chronic diseases, aretaking multiple medications, or are likely to incurhigh annual drug costs.
"If the Centers for Medicare & MedicaidServices considers medication therapy managementto be the ‘cornerstone'of the Medicaredrug benefit, as it says, then it should regulateprivate plans and not bow to them," saidMedicare Rights Center President Robert M.Hayes. "Until CMS raises the bar and requiresprofiteering drug plans to utilize the best medicationtherapy management practices availabletoday, people will suffer needlessly and havecostly hospital and nursing homes stays."