This week Senators Hagan (D- NC) and Franken (D- MN) and Representative Ross (D- AR) issued Senate and House, Dear Colleague letters, in support of this legislation. Dear Colleague letters are influential letters used within Congress to educate about the benefits of a bill to help build peer-to-peer support. Contact Senators Harkin (D) and Grassley (R) and your Congressman (Braley (D-1), Loebsack (D-2), Boswell (D-3), Latham (R-4) or King (R-5) today and encourage them to co-sponsor S 3543/HR 3108.
This bill would expand Medicare beneficiary access to MTM services. The proposed changes include:
- Expanding the list of conditions used to determine beneficiary eligibility for MTM services.
- Requiring prescription drug plan (PDP) sponsors to establish processes for identifying individuals who are not targeted beneficiaries for MTM services and who a pharmacist or other qualified provider determines may benefit from MTM services, allowing any such individual to be treated as a targeted beneficiary.
- Requiring any MTM program to offer both comprehensive and targeted medication reviews at the time of initial enrollment and of a transition of care, respectively, to individuals dually eligible for both Medicare and Medicaid (regardless of whether they are MTM-targeted beneficiaries).
- Requiring PDP sponsors to offer any willing pharmacy in its network and any other health care provider the opportunity to provide MTM services.
- Requiring PDP sponsors to reimburse pharmacies or other qualified health care providers furnishing MTM services based on the resources used and the time required to provide such services.
- Directing the Secretary of HHS to: (1) establish measures and standards for data collection by PDP sponsors to evaluate performance of pharmacies and other entities in furnishing MTM services; and (2) support the continued development and refinement of performance measures.
- Providing pharmacies and other entities that furnish MTM services with additional incentive payments based on their performance in meeting quality measures established under this Act.
Pharmacists can utilize Call to Action by NACDS to send an online letter!
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