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Medicare Advantage Medication Therapy Management

Managing complex health conditions and multiple medications can be a lot of work. To help with this journey, members with Medicare drug plan coverage may be eligible for a Medication Therapy Management (MTM) program. Quartz Medicare Advantage (HMO) offers MTM at no extra cost to you, helping you manage your medications so you can focus on feeling well.

To qualify for MTM, a member must meet all of the following criteria:

  • Members must have filled eight or more chronic Part D medications; and
  • Members must have at least three of the following seven chronic conditions
    • Alzheimer’s Disease
    • Bipolar Disease
    • Congestive Heart Failure (CHF)
    • Depression
    • End-Stage Renal Disease (ESRD)
    • Osteoarthritis
    • Schizophrenia
  • Members must be likely to incur 2024 annual costs of $5,330 for all covered chronic Part D medications.

OR

  • Are in a Drug Management Program to help better manage and safely use medications such as opioids and benzodiazepines.

If you meet all the criteria above, you will receive a letter in the mail notifying you that this program is available at no extra cost to you. The letter will include the phone number to call to start your journey to learn how to manage your medications to help you stay healthy.

Frequently asked questions about the MTM program

Is there an additional cost to participate in the MTM program?

These programs are provided at no additional cost as part of your coverage and are not considered a benefit.

How do I know if I qualify for the MTM program?

You will receive a letter in the mail notifying you that this program is available at no extra cost to you. The letter will include the phone number to call to get started.

What does the MTM enrollment mailer and medication list look like?

What does the MTM program help participants do?

The success of our MTM program is built upon our proven experience using a wide range of services designed to help members with multiple conditions by:

  • Ensuring they take their medications correctly
  • Improving medication adherence
  • Detecting potentially harmful medication uses or combinations of medications
  • Educating members and health care providers

What are the factors we looked at when creating these programs?

Our programs are evidence-based, can integrate pharmacy and medical data when available, and are built upon multiple measures demonstrating positive clinical outcomes for members like you. Pharmacists, physicians, and PhDs develop, manage, and evaluate the programs for effectiveness.

Why are consultations important?

One-on-one consultations between our clinicians and members are also important to our MTM program. These consultations ensure that members are taking their medications as prescribed by their health care provider.

What is a comprehensive medication review (CMR)?

A CMR is a review of a member’s medications (including prescription, over-the-counter (OTC), herbal therapies, and dietary supplements), which is intended to aid in assessing medication therapy as well as optimizing outcomes.

The Centers for Medicare & Medicaid Services (CMS) requires all Part D sponsors to offer an interactive, person-to-person comprehensive medication review (CMR) to all MTM-eligible members as part of MTM program. If you meet the above criteria, you will receive an MTM program enrollment mailer or phone call offering our CMR services. Also, MTM-eligible members will be included in quarterly targeted medication review (TMR) programs that assess medication profiles for duplicate therapy or drug-disease interaction in which members’ prescribers may receive a member-specific report.  

What components do we include in the CMR?

  1. Review of medications to assess medication use and identify medication-related problems. This may be conducted person-to-person or “behind the scenes” by a qualified provider and/or using computerized clinical algorithms.
  2. An interactive, person-to-person consultation performed by a qualified provider at least annually to all MTM-eligible members.
  3. An individualized, written summary of the consultation for the member, including but not limited to, a medication list, reconciled medication list, and recommended to-do list for monitoring, education, or self-management.

I have unused or expired medications and am looking for a safe way to dispose of them. How do I safely dispose of them before they do harm?

For safety reasons, dispose of unused or expired medications as soon as possible. Here are a few tips for safe disposal:

  • Find a nearby pharmacy or other local resource with a medication take-back service.
    • The US Drug Enforcement Administration (DEA) (By clicking on this link, you will leave the Quartz Medicare Advantage website) allows unused prescription medications to be returned to pharmacies or other authorized sites. Community take-back sites are the preferred method of disposing of unused controlled substances. 
    • Additional drug disposal information can be found on the DEA website (By clicking on this link, you will leave the Quartz Medicare Advantage website).
  • If you cannot get to a drug take-back location promptly, or there is none near you:
    • Mix the unused supply with an undesirable substance, such as dirt or coffee grounds.Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag, then place the sealed container in your trash. Make sure to conceal or remove any personal information, including Rx number, on the empty containers by covering them with black permanent marker or duct tape, or scratching them off to protect your privacy.Place the sealed container with the mixture and the empty drug containers in the trash. 
    • Only flush approved unused or expired medications down the toilet if indicated on the label, patient information, or no other disposal options are available.

How do I learn more about the safe disposal of medications?

The United States Department of Health and Human Services website has more information on the safe disposal of medication. (By clicking on this link, you will leave the Quartz Medicare Advantage website).

Questions?

Contact Optum Rx if you have any questions about the MTM program, at (844) 368-1961 (TTY: 711), Monday – Friday, 8 a.m. to 8 p.m. CST.

You may also contact a Quartz Champion at (800) 394-5566 (TTY: 711), Monday – Friday, 8 a.m. to 8 p.m. Oct. 1 – March 31, seven days a week, 8 a.m. to 8 p.m.

Medicare Advantage Drug Information

Looking for information on your drug plan? Reach out to a Quartz Champion, or check your formulary (drug list).