Medication Therapy Management Program (MTMP)

Superior HealthPlan has programs that help members manage their Part D and other medications in special situations. For example, some members have several complex medical conditions at one time. These members may need to take many drugs at the same time, or they could have high drug costs. A team of pharmacists and doctors developed a program for us to help these members with their care. The program is called the Medication Therapy Management Program, or MTMP.

The MTMP can help make sure that our members are using the drugs that work best to treat their medical conditions, help us to identify possible medication errors, and help improve medication adherence. The program is not considered a benefit and is voluntary and free to eligible members.

Members who are eligible for the MTMP have:

  • Three or more of the following chronic disease states:
    • Asthma
    • Hypertension
    • Dyslipidemia
    • Osteoporosis
    • End Stage Renal Disease (ESRD)
    • Mental Health-Depression
    • Diabetes
  • Eight or more chronic or maintenance Part D medications
  • Most likely have higher drug costs (more than $3,919 each year)

If you meet the criteria for the MTMP, we will automatically enroll you in the program and send you a Welcome letter indicating you have qualified for MTMP and inviting you to call for a medication review with an MTM pharmacist. If you decide not to participate, please notify us and we will withdraw your participation in the program.

The pharmacist or pharmacy intern under the direct supervision of a pharmacist will provide the following MTMP services with a final goal of helping the member reach the best therapeutic results to fit their needs:

  • An annual Comprehensive Medication Review (CMR) is conducted either by phone or a face-to-face meeting to provide a collection of all the member’s medication related information and address any medication concerns. The CMR will take approximately 45 minutes.
  • A Personal Medication List (PML) to record all prescription and over-the-counter medications which can be updated as needed (click here for sample PML)
  • A Medication Action Plan (MAP) made specific for the member after counseling to help them follow steps while taking medications to reach their health goals
  • The PML and MAP are printed and either mailed or hand delivered within 14 calendar days of the Comprehensive Medication Review
  • Quarterly Targeted Medication Reviews (TMR) which identify potential safety concerns, such as drugs which are not recommended for use in those over age 65, or any drug therapies that the member should be on, but are not, based on their conditions. If issues are identified, a letter is sent to the member and includes ways to help improve medication use. Additionally, a fax communication may be sent to the prescriber.

If the member is unable to participate, an authorized individual may participate on the member’s behalf. In addition, the pharmacist may work with other clinical team members if more services are needed in order to help the member reach their health goals.

To learn more or get additional information, please call Member Services. Contact information is at the bottom of this webpage. Member Services is prepared to answer questions about the MTMP.


Last Updated: 09302016
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