The Story: The House Energy and Commerce Committee’s Health Subcommittee held a hearing on Wednesday on the Medicare Part D Medication Therapy Management Program to consider recommendations for reforming the current MTM program so it better serves beneficiaries.
The Background
The Medicare Part D program was established in 2003 when the Medicare Modernization Act was signed into law, creating the Medication Therapy Management (MTM) program. In September 2015, the Centers for Medicare and Medicaid Services (CMS) announced a new Part D Enhanced Medication Therapy Management model that will be run out of the CMS Center for Medicare and Medicaid Innovation (CMMI) to determine if more flexibility in MTM design and additional incentives will result in better outcomes for the MTM program.
The Specifics
NACDS submitted a statement to the Subcommittee reinforcing the healthcare and cost benefits of MTM, and provided evidence-based solutions to bolster the recommendations for revisions to the MTM program. In its comments, NACDS expressed support for bipartisan legislation introduced earlier this year by Sens. Pat Roberts (R-KS) and Jeanne Shaheen (D-NH) which would help patients with specific chronic conditions receive these MTM services. Specifically, S. 776, the Medication Therapy Management Empowerment Act of 2015 would provide access to MTM for Medicare Part D patients with diabetes, cardiovascular disease, COPD and cholesterol.
NACDS also pointed to compelling findings from the Congressional Budget Office and a recent study in the policy journal Health Affairs that show that an increase in prescription drug use is associated with significant decreases in Medicaid costs for patients.
What Else?
Jesse McCullough, a registered pharmacist and Rite Aid’s director of field clinical services, provided testimony at the hearing on the benefits of early intervention for patients with chronic conditions, and the changing role pharmacists have had since the implementation of the Part D program. NACDS also submitted comments to the CMMI, at their request, for feedback on the proposed Enhanced MTM Model program.
