WASHINGTON — A bipartisan group of congressional representatives is urging that retail pharmacists play a part in a new initiative designed to improve the use of medication therapy management in Medicare.
Forty-four members of the House of Representatives — 24 Republicans and 20 Democrats — signed a letter to Secretary of Health and Human Services Sylvia Burwell, according to the National Association of Chain Drug Stores.
The letter refers to the announcement by the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare & Medicaid Innovation (CMMI) in September of the creation of the Medicare Part D enhanced MTM model.
“We believe the proposed enhanced MTM model to be a positive step forward in improving the Part D MTM program,” the House members wrote. “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 letter went on 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, the letter contended, while reducing health care costs through lower hospitalizations and readmissions, and allowing beneficiaries to be more involved in their own medication management.
“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 of the most trained and highly skilled providers of medication management services, local retail community pharmacists.”
The CMMI initiative includes a pilot program — the Enhanced MTM Demonstration — that would allow Part D plans to utilize new and innovative approaches to MTM, such as more efficient outreach and targeting strategies, and tailoring the level of services to the beneficiary’s needs.
Stand-alone prescription drug plans in 11 states can participate in the pilot, and throughout the fall NACDS had been advising its members about the need to approach plans with proposals for target populations and intervention approaches.
The association noted in its outreach efforts that interested companies needed to act quickly, because the time line for plans to submit applications and launch the demonstration are very tight.
The deadline for plans to submit applications is January 8. The program is then due to launch in January 2017.
NACDS had also approached MTM supporters in the House and Senate about emphasizing the importance of retail pharmacist participation in the pilot programs, and the association praised the letter from the members of the House of Representatives.
“NACDS appreciates the engagement of these congressional leaders who have urged retail pharmacy’s participation in this program,” said NACDS president and chief executive officer Steve Anderson. “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.”