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Lawmakers see pharmacists as linchpin for MTM

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House coalition hails CMS pilot of Part D Enhanced MTM Model

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ARLINGTON, Va. — A bipartisan coalition of congressmen is urging the participation of retail pharmacists in a new initiative to improve the use of medication therapy management (MTM) in Medicare.

The National Association of Chain Drug Stores said Wednesday that 44 members of the U.S. House of Representatives have sent a letter to Secretary of Health and Human Services Sylvia Burwell to express their support for efforts by the Centers for Medicare & Medicaid Services (CMS) to test alternative approaches to improve MTM services in Medicare Part D.  Signing the letter were 24 Republicans and 20 Democrats, including 11 members of the House Energy and Commerce Committee.

The letter refers to a September 2015 announcement by CMS and the Center for Medicare and Medicaid Innovation (CMMI) of the creation of the Part D Enhanced MTM model. NACDS said the initiative is an opportunity for stand-alone basic prescription drug plans (PDP) in selected regions to offer innovative MTM programs, aimed at improving the quality of care while also reducing costs.

Plans call for CMS to gauge the results of new approaches over five years to help achieve better alignment of PDP sponsor and government financial interests while creating incentives for robust investment and innovation in better MTM targeting and interventions.

“We believe the proposed enhanced MTM model to be a positive step forward in improving the Part D MTM program. However, we also believe that without participation of retail community pharmacists, the testing of enhanced MTM models will fall short of achieving the maximum potential in terms of positive outcomes and impact on beneficiary health,” the lawmakers wrote in the letter. “Therefore, we are writing today to encourage CMS and CMMI to take steps to ensure that retail community pharmacists are incorporated into the enhanced MTM models to be tested. MTM provided by retail pharmacists improves patient health, reduces health care costs through lower hospitalizations and readmissions, and allows beneficiaries to be more involved in their medication management.”

In their comments, the House members spotlighted the pivotal role of the pharmacist in providing MTM services.

“While CMMI did note the importance of pharmacists in its announcement of the enhanced MTM model, it is vital that CMMI continue to recognize the importance of pharmacists as it begins to enter into partnerships with plans,” the letter stated. “CMMI should work with plans proposing to utilize retail community pharmacies in their enhanced models. Our seniors deserve the most robust and effective MTM program possible, one that includes the utilization the most trained and highly skilled providers of medication management services, local retail community pharmacists.”

NACDS said that during the fall it advised member companies about the need to approach plans with proposals for target populations and intervention approaches — and the need to do so promptly, since the timeline for plans to submit applications is Jan. 8, 2016. The program is slated to launch in January 2017.

“NACDS appreciates the engagement of these congressional leaders who have urged retail pharmacy’s participation in this program,” NACDS president and chief executive officer Steve Anderson said in a statement. “The bipartisan support for this effort is consistent with the strong support for the MTM Empowerment Act in the current and prior Congresses, and that shows the strong interest in leveraging the expertise and accessibility of pharmacists to confront the severe health consequences and the $290 billion in annual costs that are associated with not taking medications as prescribed.”


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