2023 Medication Therapy Management Program

What is Medication Therapy Management (MTM)?

Medication Therapy Management is a clinical program that provides education and information about your medicines. As part of this program, Tufts Health One Care members are provided with a pharmacist’s review of their medicines to look for ways to improve their drug therapy. Services offered through the MTM program include a Comprehensive Medication Review and Targeted Medication Reviews.

Who is eligible?

Members who have Tufts Health One Care (Medicare-Medicaid Plan) must meet the following three criteria, or be enrolled in the plan’s Drug Management Program, to be eligible for MTM services:

  1. Have at least 3 of the following chronic diseases:
    • Asthma
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Chronic Heart Failure (CHF)
    • Diabetes
    • Dyslipidemia (high cholesterol)
    • Hypertension (high blood pressure)
  2. Taking at least 8 Part D covered medications
  3. Have at least $4,935 in estimated annual costs on Part D covered medications

What are the benefits of MTM?

  • Pharmacists lower the risk of drug related problems, including medication errors and side effects
  • Pharmacists offer helpful tips on how to take your medicines
  • Pharmacists identify ways to reduce duplicative therapy

What is a Comprehensive Medication Review?

A Comprehensive Medication Review is a one-on-one telephone or face-to-face consultation with a pharmacist.  During the CMR, the member’s entire medication profile is reviewed to make sure the therapy is appropriate. The CMR includes all prescription medications, over-the-counter medications, herbal supplements, and sample medications.  The review should take no more than 20 minutes. Best of all, the CMR gives the member an opportunity to ask the pharmacist any questions he or she may have about the medications he or she is currently taking. Following the CMR, the pharmacist sends the member a Recommended To-Do List and a Medication List.

What is a Targeted Medication Review (TMR)?

During a Targeted Medication Review, a pharmacist looks for opportunities to improve a member’s medication regimen. Following a TMR, a pharmacist may reach out to a member and/or his or her providers to discuss the findings. Targeted Medication Reviews are conducted on a quarterly basis for members who have not opted-out of the program.

How do I participate in the MTM program?

If you are eligible for the MTM program, you will receive an enrollment letter from our MTM partners at OptumRx. You may also receive a phone call. The letter will provide information about how to schedule your Comprehensive Medication Review with a pharmacist, which may be done by returning the enclosed form or by calling the provided toll-free number. OptumRx may also contact you by phone from their Medication Management Center to offer you a CMR.

For members not interested in participating in the MTM program, information regarding how to opt-out is also provided in the enrollment letter.
Participation in the MTM program is voluntary and available at no cost to Tufts Health One Care members. One Care members may participate in this program at no cost even though the program is not considered a covered benefit.

How do I safely dispose of my unused and/or expired medications?

It is important to properly dispose of unused and/or expired medications as soon as possible before they can do harm.  The following are ways to safely get rid of medications you no longer need:

  • Find a nearby pharmacy or other local resource with a medication take back service.*

The US Drug Enforcement Administration (DEA) sponsors two formal drug Take Back Days a year: in April and October.  They also endorse year-round collection at select pharmacies and other authorized sites.  You can find a site in your community by using the DEA search engine.  More information on the drug Take Back Days is available on the DEA website at www.deatakeback.com.

*This is the preferred method for disposing of unused controlled substances, such as opioid medications.

  • Dispose of the medication in your household trash.

If you are unable to bring your unused medication to a DEA-endorsed take back site, there is a way to safely dispose your medication at home:

  • Remove the medication from its original container and mix it with an undesirable substance such as kitty litter, dirt or used coffee grounds.
  • Put the mixture into a sealable bag or disposable container with a lid, such as an empty margarine tub, then place the sealed container in your trash.
  • To protect your privacy, when disposing your original prescription containers, make sure to conceal or remove any personal information, including Rx number.  You can do this by covering it with black permanent marker or duct tape, or by scratching it off.

Can I flush my medication down the toilet?

Trace amounts of medications that are flushed down the toilet may end up in our water supply.  It is important to only flush unused or expired medications down the toilet if the prescription drug labeling or patient information that came with the medication said to do so, or no other disposal options are available.

More information on the safe disposal of medications can be found on the United States Department of Health and Human Services (HHS) website: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

How do I find out more?

For questions about the Tufts Health One Care Medication Therapy Management program in partnership with OptumRx, please contact our Member Services team at 1-800-701-9000 (TTY: 711).

Tufts Health One Care is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.

 


Disclaimers

Tufts Health One Care is a health plan that contracts with both Medicare and MassHealth to provide benefits of both programs to enrollees. It is for people with both Medicare and MassHealth ages 21 through 64 at the time of enrollment.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits.
For more information contact the plan or read the Member Handbook (2023).

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. The call is free.

Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-393-3154 (TTY: 711), siete días de la semana, de 8 a.m. a 8 p.m. La llamada es gratuita.

You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY:711), seven days a week, from 8 a.m. to 8 p.m. The call is free.

The List of Covered Drugs and/or pharmacy and provider networks may change from time to time throughout the year. We will send you a notice before we make a change that affects you.

Benefits may change on January 1 of each year.

 

H7419_6530 CMS Approved
Page modified on: 10/10/2019 5:00:45 PM