Position Statements
Medical Loss Ratio (MLR)
Supported incorporating MTM into the MLR as a
part of the “qualifying health improvement activity”
Comprehensive Medication Management (CMM)
Expressed concern about the potential for confusion between an established industry term Medication Therapy Management (MTM) and CMM
CMRs in Long-Term Care (LTC)
Emphasized the CMR should be interactive, person-to-person and conducted in real time with the patient and/or other authorized individual
Pay-for-Performance (P4P)
Expressed belief that P4P and MTM are not mutually exclusive, and hybrid strategies featuring elements of both are superior to approaches from either end of the continuum
Memos to CMS
CMR Completion Rate
Recommended extending CMR Completion Rate as a display measure for a second year to allow for more consistency in MTMP reporting data
CMR Quality
Proposed companion measure of number of drug therapy problems resolved per CMR to ensure quality of service and measurable effectiveness
MTMP Eligibility
Recommended CMS consider establishing a minimum percentage of a plan sponsor’s overall population that must qualify for the sponsor’s MTM program
Definitions and Standards
Recommended standards created by the National MTM Advisory Board to help guide Medicaid agencies in defining MTM programs
Drug Therapy Problem (DTP)
Comprehensive Medication Review
Adopted by CMS in 2013 Call Letter