Medication Therapy Management
Commonwealth Care Alliance

Medication Therapy Management Program

What is the Medication Therapy Management (MTM) Program?

The MTM program is designed by Medicare to help members get the most benefit from their medications. This program is not a standard benefit, but it is offered to eligible Medicare Part D enrollees who have multiple chronic conditions and take several medications.

Commonwealth Care Alliance has partnered with Clinical Support Services (CSS) to provide MTM services. If you meet the MTM program eligibility criteria, a pharmacist or specially trained clinician will work with you and your doctor to make sure all the medications you take are necessary, safe, and effective. This is a free service for eligible members.

  • What services are offered in the MTM Program?

    If you meet the MTM program eligibility criteria, you will receive a letter explaining the program and you will be offered the chance to talk with a pharmacist or specially trained clinician by phone to review all your current medications. If you do not respond to our letter, we will contact you by phone to explain the program and schedule an appointment with a pharmacist.

    This telephone call is called a Comprehensive Medication Review. It generally takes about 20-30 minutes and it includes the following:

    • Speaking with a pharmacist about your prescription medicines, over-the-counter medicines, and herbal and dietary supplements.
    • The pharmacist reviews the medications you take, checks for any problems with your medications, and talks with you about any concerns or questions you have about your medications.
    • After you talk with the pharmacist, you get a written summary that includes a letter, a medication action plan, and an updated medication list.
    Download a blank copy of the Personalized Medication List (pdf)

    Additionally, Targeted Medication Reviews are performed quarterly with the enrollee’s care team to notify them of actual or potential medication-related concerns. As always, your prescribing doctor will decide whether to consider our suggestions. Your prescription drugs will not change unless you and your doctor decide to change them.
  • Who is eligible for the MTM Program?

    Members are eligible for the MTM program if they meet ALL of the following criteria:

    • Have at least 3 of the following chronic diseases:
      • Alzheimer’s disease
      • Osteoarthritis
      • Osteoporosis
      • Rheumatoid arthritis
      • Diabetes
      • End-stage renal disease
      • Asthma
      • Chronic obstructive pulmonary disease (COPD)
      • Chronic alcohol and other drug dependence
      • HIV/AIDS
    • Are taking at least 8 drugs covered by Medicare Part D
    • Are likely to incur annual Medicare Part D costs greater than or equal to $3,967

For more information, please call our Member Services team at 866-610-2273 (TTY 711). We're available 8 a.m. to 8 p.m., 7 days a week.

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