National MTM Advisory Board Releases Position on Medication Therapy Management Program Eligibility

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Recommendation Aims to Enhance MTM program Eligibility Criteria by Establishing a Minimum Threshold

The National MTM Advisory Board has released its recommendations for Medicare Part D Medication Therapy Management (MTM) Program eligibility criteria. While Medicare plan-to-plan inconsistency in MTM eligibility criteria has been somewhat limited due to refinements introduced by the Centers for Medicare and Medicaid Services (CMS), wide variability persists.

The National MTM Advisory Board recommends consideration of the establishment of a minimum percentage of a plan sponsor’s overall population which must qualify for the MTM program offered by the sponsor. The sponsor would have the autonomy to establish plan-specific criteria for MTM eligibility so long as the MTM eligible population meets or exceeds the threshold established by CMS. This would allow sponsors to enroll the beneficiaries they believe would benefit most from MTM services.

View the full National MTM Advisory Board Position Paper on Medication Therapy Management Program (MTMP) eligibility criteria.

About the National MTM Advisory Board
Formed in 2010, the National MTM Advisory Board brings together representatives from multiple stakeholder groups to build consensus and influence policy development in the MTM industry. The Board incorporates a diverse mix of viewpoints and experience from payors, consumers, prescribers and pharmacies. As thought leaders, members of the Board address both the short and long-term positioning of MTM services within the larger healthcare picture. OutcomesMTM provides administrative support to the board.

About OutcomesMTM
OutcomesMTMâ„¢ leverages local relationships among pharmacists, patients and prescribers to advance the Face-to-Face Difference® in Medication Therapy Management (MTM). OutcomesMTM connects Medicare, Medicaid, commercial health plans, employers and other healthcare payors with a national network of 90,000 local chain, independent, consultant and health-system pharmacy providers.

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Steve Berry
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