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NCPA supports measure to bolster Part D MTM coverage

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ALEXANDRIA, Va. — The National Community Pharmacists Association has called on the Senate Finance Committee to support a proposal that would expand coverage of medication therapy management (MTM) programs in Medicare Part D.

NCPA said Wednesday that Sens. Pat Roberts (R., Kan.) and Robert Casey (D., Pa.) have proposed an amendment to legislation before the Senate committee that would temporarily prevent cuts to Medicare payments to doctors. The amendment would require the Centers for Medicare & Medicaid Services (CMS) to determine if the coverage of MTM services for patients with one chronic condition would reduce Medicare spending overall through the avoidance of costlier treatments such as hospitalizations.

If CMS determines that the expansion in coverage would reduce costs, then the expansion of MTM coverage would be required, according to NCPA. Currently, only patients with specific, multiple chronic conditions are eligible for MTM services.

NCPA on Wednesday sent a letter to Senate Finance Committe leaders to express its support for the amendment. The association said the proposal is scheduled for a vote as soon as Thursday, Dec. 12.

"Community pharmacists are highly trained medication experts and expanding the MTM services that they provide can achieve better health outcomes and lower overall costs," NCPA chief executive officer B. Douglas Hoey said in a statement. "The challenges of not adhering to prescription drug therapy are real and expensive, and pharmacist-delivered MTM services can make a world of difference for patients. NCPA commends Sens. Roberts and Casey for their work on this and encourages all senators on the committee to support this bipartisan amendment."

The association added that the Roberts-Casey amendment arose from the Medication Therapy Management Empowerment Act (S. 557) introduced by Sen. Kay Hagan (D., N.C.) and co-sponsored by Casey, Roberts and 28 other senators.

Noting that MTM can yield significant cost savings, NCPA cited a Minnesota study finding a 12-to-1 return-on-investment for MTM. The association also reported that in North Carolina MTM programs helping seniors resulted in a 13-to-1 return.


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