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Medication Therapy Management Program

If you are in a Medicare drug plan and you have complex health needs, you may be able to participate in a Medication Therapy Management (MTM) program. The MTM program is required by the Centers for Medicare and Medicaid Services (CMS), and is a service offered by Centers Plan for Healthy Living (Centers Plan for FIDA Care Complete) at no additional cost to you!.

This program helps you and your provider make sure that your medications are working to improve your health. A pharmacist or other health professional will give you a comprehensive review of all your medications and talk with you about:

  • How to get the most benefit from the drugs you take
  • Any concerns you have, like medication costs and drug reactions
  • How best to take your medications
  • Any questions or problems you have about your prescription and over-the-counter medication

You’ll get a written summary of this discussion. The summary has a medication action plan that recommends what you can do to make the best use of your medications. You’ll also get a personal medication list that will include all the medications you’re taking and why you take them.

It is a good idea to schedule your medication review before your yearly “Wellness” visit, so you can talk to your doctor about your action plan and medication list. Bring your action plan and medication list with you to your visit or anytime you talk with your doctors, pharmacists, and other health care providers. Also, take your medication list with you if you go to the hospital or emergency room.

To take part in this program, you must meet certain criteria set forth, in part, by CMS. These criteria are used to identify people who have multiple chronic diseases and are at risk for medication-related problems. If you meet these criteria, you will be enrolled in the program, and sent an introductory letter and information about the program. The packet you receive will include information on how to access the program, how to request a Comprehensive Medicare Review (CMR), and how to opt-out of the program. Your enrollment in MTM is voluntary, and does not affect Medicare coverage for drugs covered under Medicare.

To qualify for Centers Plan for Healthy Living’s MTM program you must:

  1. Have at least 2 of the following conditions or diseases: Chronic Heart Failure (CHF), Diabetes, Dyslipidemia, Hypertension, Asthma, Chronic Obstructive Pulmonary Disease (COPD), AND
  2. Take at least 7 covered Part D medications, AND
  3. Be likely to have medication costs of covered Part D medications equal to or greater than $1,011 per quarter ($4,044 per year).

 

If you have any questions about this program, or want to find out if you are eligible to participate, please contact

  • Our Pharmacy Helpdesk at 1-888-266-7460, seven days a week, from 8 am to 8 pm.  TTY users please call 1-800-421-1220 or 711

OR

  • Your Care Manager at 1-800-466-2745, seven days a week, from 8 am to 8 pm.  TTY users please call 1-800-421-1220 or 711

As indicated above, the MTM program includes a free discussion and review of all of your medications by a pharmacist or other health professional to help you use your medications safely. This Comprehensive Medication Review (CMR), is provided via telephone by The University of Arizona, Medication Management Center (Sinfonia-Rx), which provides this service on behalf of Centers Plan for Healthy Living (Centers Plan for FIDA Care Complete). During the CMR, generally completed at least once every three months (i.e. quarterly) by telephone, Sinfonia-Rx will review your entire medication profile with you (including prescriptions, over-the-counter medications/items, herbal supplements and samples) for the appropriateness of therapy.  They will discuss the purpose and direction of each medication with you, and document them on your Personal Medication List; and they will discuss disease-specific goals, medication related problems and address any questions you may have. After this discussion, you will get a written summary of this call to help you get the most from your medications. You can take this summary with you when you talk with your doctors. Additional services are offered to both you and your doctors, which are aimed to improve your health.
If you take many medications for more than one chronic health condition contact your drug plan to see if you’re eligible for MTM, or for more information, please contact 1-888-266-7460. 7 days a week from 8 am to 8 pm. TTY users please call 1-800-421-1220.

If you would like a blank copy of a Personal Medication List, please click on the link below:
Personal Medication List

Last modified: Apr 4, 2019