Medication Therapy Management

Medication Therapy Management Program (MTM)

Prescription drugs can play a vital role in keeping you healthy, but sometimes keeping track of your medication or dealing with side effects is challenging. That’s why CDPHP has partnered with Capital Rx and OutcomesMTM to administer our Medication Therapy Management Program (MTM). This no-cost service helps you get the most from your prescriptions drug benefit by:

• Preventing or reducing drug-related risks

• Increasing your awareness about the medications you take

• Supporting good habits

• Providing information for safe medication-disposal options

How do I know if I qualify for the program?

If you qualify, you will receive a letter in the mail. You may also receive a phone call, inviting you to participate in a one-on-one medication review.

Who qualifies for the program?

As a Medicare Advantage member, you will automatically be enrolled in the program at no cost to you if you:

1. Have coverage limitation(s) in place for medication(s) with a high risk for dependence and/or abuse, or

2. Meet the following criteria:

   • You have three or more of these conditions:

     1. Asthma
     2. Chronic heart failure (CHF)
     3. Chronic obstructive pulmonary disease (COPD)
     4. Diabetes
     5. Dyslipidemia
     6. Hypertension
     7. Chronic alcohol or drug dependence
     8. HIV/AIDS
        
        

   • You take eight more more Medicare Part D covered maintenance drugs

   • You are likely to spend more than $5,330 in prescription-drug costs in 2024

Your participation is voluntary, and does not affect your coverage. The MTM program is available only to qualified Medicare Advantage members.

If you are a CDPHP member and do not qualify for this program but would like to review your medications with a pharmacist, you can use the CDPHP MedCheck program.

What services are included in the program?

Comprehensive Medication Review

A pharmacist will speak with you one-on-one and review your medication, answer questions, and address concerns you have about the medications you take, including:

The pharmacist will offer ways to manage your conditions with the medications you take. If more information is needed, the pharmacist may contact your prescribing doctor. The review takes about 30 minutes and is usually offered once each year for qualified members. At the end of your discussion, the pharmacist will provide you a Personal Medication List with the medications you discussed during your review.

You will also receive a Medication Action Plan. Your plan may include suggestions from the pharmacist for you and your doctor to discuss during your next doctor visit.

Targeted Medication Review
During this review, a pharmacist will contact your doctor with suggestions about prescription drugs that may be safer, or work better than your current drugs. As always, your prescribing doctor will decide what’s best for you; your prescription drugs will not change unless you and your doctor decide to change them. A pharmacist may also contact you with suggestions about your medications.

Who will contact me about the review?
You may receive a call from a pharmacy where you recently filled one or more of your prescriptions. You will be given the option to choose an in-person review or a phone review.

You may be contacted by an OutcomesMTM call center pharmacist to provide your review, and ensure that you have access to the service if you want to participate. These reviews are conducted by phone.

Why is a review with a pharmacist important?

Different doctors may write prescriptions for you without knowing all the prescription drugs or OTC medications you take. Therefore a pharmacist will:

• Discuss how your prescription drugs and OTC medications may affect each other

• Identify any prescription drugs and OTC medications that may cause side effects and offer suggestions to help

• Help you get the most benefit from all of your prescription drugs and OTC medications

• Review opportunities to help you reduce your prescription drug costs

How do I benefit from talking with a pharmacist?

• Discussing your medications can result in real peace of mind knowing that you are taking your prescription drugs and OTC medications safely

• The pharmacy can look for ways to help you save money on your out-of-pocket prescription drug costs

• You benefit by having a Personal Medication List and a Medication Action Plan to keep and share with your doctors and health care providers

How can I get more information about the program?

Please contact CDPHP if you would like additional information on our program, or if you do not want to participate after being enrolled in the program. Our number is (518) 641-3220 ext. 1 (M-F 8 am – 5 pm EST).

How do I safely dispose of medications I don’t need?

CDPHP is dedicated to providing you with information about safe medication disposal. Medications that are safe for you may not be safe for someone else. Unneeded medications should be disposed of as soon as possible. You can discard your unneeded medications through a local safe disposal program or at home for some medications.

• Locating a community safe drug disposal site
  A drug take back site is the best way to safely dispose of your medications. To find drug take back sites near you, visit the website below and enter your location:
  U.S. Department of Justice controlled substance public disposal locations search
  
  Some pharmacies and police stations offer on-site drop-off boxes, mail-back programs, and other ways for safe disposal. Call your pharmacy or local police department (non-emergency number) for disposal options near you.

• Mailing medications to accepting drug disposal sites
  Medications may be mailed to authorized sites using approved packages. Information on mail-back sites can be found at www.deatakeback.com

• Safe at-home medication disposal
  You can safely dispose of many medications through the trash. Visit the following website to learn more about safe at-home disposal: https://www.hhs.gov/opioids/prevention/safely-dispose-drugs/index.html

Follow these steps for medication disposal in the trash:

• Remove medication labels to protect your personal information

• Mix medications with undesirable substances, such as dirt or used coffee grounds

• Place mixture in a sealed container, such as an empty margarine tub