2022 Medication Therapy Management
If you’re in a Medicare drug plan and you have complex health needs, you may be able to participate in a Medication Therapy Management (MTM) program. MTM is a service offered by Centers Plan for Healthy Living at no additional cost to you! The MTM program is required by the Centers for Medicare and Medicaid Services (CMS). This program helps you and your doctor make sure that your medications are working. It also helps us identify and reduce possible medication problems.
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 are identified as at risk for an opioid addiction, you will meet the criteria for inclusion in the program. If you meet these criteria, you will be invited to participate in the program and we will send you information about the program, including how to access 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 meet ALL of the following criteria:
- Have at least 3 of the following conditions or diseases: Chronic Heart Failure (CHF), Diabetes, Dyslipidemia, Hypertension, Asthma, Chronic Obstructive Pulmonary Disease (COPD), AND
- Take at least 8 covered Part D medications, AND
- Be likely to have medication costs of covered Part D medications equal to or greater than $1,174 per quarter ($4,696 per year).
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 review, or CMR, is provided via telephone by The University of Arizona, Medication Management Center, which provides this service on behalf of Centers Plan for Healthy Living. 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 member service 7 days a week 8am-8pm at 1-877-940-9330 (toll free) TTY users call 711.
IMPORTANT UPDATES TO 2022 FORMULARY
MAPD PAWEB (Prior Authorization Requirements) - Last updated 09/28/22
MAPD STEPWEB (Step Therapy Requirements) - Last updated 09/28/22
MAPD Future Formulary - Last updated 08/2022
DSNP/ISNP/MAP PAWEB (Prior Authorization Requirements)- Last updated 09/28/22
DSNP/ISNP/MAP STEPWEB (Step Therapy Requirements)- Last updated 09/28/22
DSNP/ISNP/MAP Future Formulary - Last updated 08/2022
Please note this Medication Therapy Management (MTM) Program is not considered a benefit.