2021 Medication Therapy Management Program
The Medication Therapy Management (MTM) program helps you with your medications.
If you receive your Medicare Part D drug coverage through Tufts Health Unify (Medicare-Medicaid Program), you may be eligible for a medication therapy management (MTM) program.
What is the MTM program?
This program was created to help us provide better care for our members. We have partnered with OutcomesMTM to provide this important service.
Specially trained and qualified providers, such as pharmacists and nurses, will work with you and your provider to make sure that your medications are appropriate, safe and effective. We will also look for ways to save you money while optimizing your therapy and treatment.
Our MTM team will review your medications for any potential issues and notify your provider if any are found. This program is not considered a benefit and is a free service for eligible beneficiaries. Participation in the program is always voluntary, and you may choose not to participate or disenroll at any time.
Who is it for?
Enrollment in this program is automatic if you meet specific criteria based upon:
- The number of certain chronic conditions you may have
- The number of covered Part D medications you may take
- The estimated annual cost for your covered Part D medications
2021 MTM Program Criteria
As a member of Tufts Health Unify, you will be automatically enrolled in the MTM program if you meet the following criteria:
- You have at least three (3) of the following chronic conditions:
- Diabetes mellitus
- Chronic obstructive pulmonary disease (COPD)
- High blood pressure (hypertension)
- High cholesterol (dyslipidemia)
- Congestive heart failure (CHF)
- You have claims for six (6) or more different covered Part D medications
- You have at least $4,255 in estimated annual drug costs for covered Part D medications
If you are eligible for the MTM program, you will receive a welcome letter from our MTM partner, OutcomesMTM. Within a few weeks of receiving the letter, you will receive a call from one of OutcomesMTM’s call center pharmacies (MedWatchers or CHC Health) to set up an appointment to speak to a clinical staff member and to complete the Comprehensive Medication Review (CMR). We encourage you to take full advantage of this service.
What is a Comprehensive Medication Review?
The Comprehensive Medication Review or CMR is done over the phone by a pharmacist or other qualified provider. Your medication history (prescription and over-the-counter), lifestyle and medical history will be reviewed. Based on this information, the pharmacist may offer recommendations or suggestions related to medication therapy. Then, a Medication Action Plan summarizing any concerns and a Personal Medication List are sent to you by mail within 14 days. This information, along with any recommendations, is also sent to your physician. A CMR for all eligible members is done at least once a year and should take between 15 to 20 minutes.
In addition to the CMR, Targeted Medication Reviews (TMR) are conducted four times a year. During a TMR, the pharmacist will assess your medication use and monitor for any new potential drug therapy issues. Any recommendations that are identified will be sent to your physician.
Tufts Health Unify members:
Click here to print a blank copy of the Personal Medication List to keep for your records and share with your provider. You may also contact our member services team to request a copy.
H7419_6530 CMS Approved
Page modified on: 10/10/2019 5:00:45 PM