Board Actions

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