Medication Therapy Management

Medication Therapy Management

Medication Therapy Management Program (MTM)

Prescription drugs can play a vital role in keeping you healthy, but sometimes keeping track of your medication or dealing with side effects is challenging. That’s why CDPHP has partnered with CVSHealth and OutcomesMTM to administer our Medication Therapy Management Program (MTM). This no-cost service helps you get the most from your prescriptions drug benefit by:

  • Preventing or reducing drug-related risks

  • Increasing your awareness about the medications you take

  • Supporting good habits

How do I know if I qualify for the program?

If you qualify, you will receive a letter in the mail. You may also receive a phone call, inviting you to participate in a one-on-one medication review.

Who qualifies for the program?

As a Medicare Advantage member, you will automatically be enrolled in the program at no cost to you if:

  1. You take eight or more Medicare Part D covered maintenance drugs, and

  2. You have three or more of these ongoing conditions:

    • Asthma

    • Chronic obstructive pulmonary disease

    • Diabetes

    • Depression

    • Osteoporosis

    • Chronic heart failure

    • Cardiovascular disorders such as high blood pressure, high cholesterol or coronary artery disease, and

  3. 3. You reach $4,376 in annual prescription drug costs paid by you and CDPHP.

Your participation is voluntary, and does not affect your coverage. The MTM program is available only to qualified Medicare Advantage members.

If you are a CDPHP member and do not qualify for this program but would like to review your medications with a pharmacist, you can use the CDPHP MedCheck program.

What services are included in the program?

Comprehensive Medication Review

A pharmacist will speak with you one-on-one and review your medication, answer questions, and address concerns you have about the medications you take, including:

  • Prescription drugs

  • Over-the-counter (OTC) medicines

  • Herbal therapies

  • Dietary supplements and vitamins

The pharmacist will offer ways to manage your conditions with the medications you take. If more information is needed, the pharmacist may contact your prescribing doctor. The review takes about 30 minutes and is usually offered once each year for qualified members. At the end of your discussion, the pharmacist will provide you a Personal Medication List with the medications you discussed during your review.

You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor visit.

Targeted Medication Review
During this review, a pharmacist will contact your doctor with suggestions about prescription drugs that may be safer, or work better than your current drugs. As always, your prescribing doctor will decide what’s best for you; your prescription drugs will not change unless you and your doctor decide to change them. A pharmacist may also contact you with suggestions about your medications.

Who will contact me about the review?
You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.

You may be contacted by an OutcomesMTM call center pharmacist to provide your review, and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.

Why is a review with a pharmacist important?

Different doctors may write prescriptions for you without knowing all the prescription drugs or OTC medications you take. Therefore a pharmacist will:

  • Discuss how your prescription drugs and OTC medications may affect each other

  • Identify any prescription drugs and OTC medications that may cause side effects and offer suggestions to help

  • Help you get the most benefit from all of your prescription drugs and OTC medications

  • Review opportunities to help you reduce your prescription drug costs

How do I benefit from talking with a pharmacist?

  • Discussing your medications can result in real peace of mind knowing that you are taking your prescription drugs and OTC medications safely

  • The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs

  • You benefit by having a Personal Medication List and a Medication Action Plan to keep and share with your doctors and health care providers

How can I get more information about the program?

Please contact CDPHP if you would like additional information on our program, or if you do not want to participate after being enrolled in the program. Our number is (518) 641-3220 ext. 1 (M-F 8 am – 5 pm EST).

CDPHP Medicare Advantage is an HMO and PPO plan with a Medicare contract. Enrollment in CDPHP Medicare Advantage depends on contract renewal.

Y_0019_22_16818 – last updated 10/01/2021