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Medication Therapy Management

We have a number of Quality Assurance and Utilization Management Initiatives designed to improve quality, prevent over- and under-utilization and reduce costs. These programs include but are not limited to:

  • Medication Therapy Management (MTM)
  • Concurrent Drug Utilization Review
  • Retrospective Drug Utilization

What is the Medication Therapy Management (MTM) Program?

The MTM program is a service for members with multiple health conditions and who take multiple medicines. This program helps you and your doctor make sure that your medicines are working to improve your health.

Who is eligible for the MTM Program?

To qualify for the MTM program, you must be eligible. Please see below for those details. If you qualify, you will be auto-enrolled into the program and the service is provided at no additional cost to you.

  1. You have three or more chronic health problems. These may include:
    • Chronic Heart Failure
    • Diabetes
    • High blood fat levels
    • High blood pressure
    • Rheumatoid Arthritis
  2. You take eight or more daily medicines covered by Medicare Part D.
  3. You spend $4,255 or more per year on Part D covered medications.

You may choose not to participate in the program, but it is recommended that you make use of this free service.

Get more information about the MTM Program

Download the PDF below to get more details about the Medication Therapy Management (MTM) program and how it may help you.

H6229_20_117631_U CMS Accepted 01/01/2020 Page Last Updated on 04/24/2020