NACDS commends CMS for MTM boost for patients in 2010
ALEXANDRIA, Va. Following the release of the Centers for Medicare and Medicaid Services’ final “call letter” for the 2010 plan year, the National Association of Chain Drug Stores expressed support for a provision that will improve the medication therapy management benefit under Medicare Part D.
NACDS commended CMS for including positive MTM changes in the final call letter, which will help open the door to improved MTM availability and offerings. In addition to improving standards for targeting of MTM services, the final call letter requires plans to offer an enhanced menu of MTM interventions, such as a comprehensive medication review by a pharmacist or other qualified provider, at least annually and quarterly targeted medication reviews for all beneficiaries enrolled in MTM programs. These uniform standards will help enhance the value of MTM services offered to Medicare beneficiaries.
As envisioned by the Medicare Modernization Act, MTM is a program of drug therapy management intended to ensure that drugs are used appropriately in order to optimize therapeutic outcomes through improved medication use and to reduce the risk of adverse events.
“We are pleased that CMS plans to enhance MTM programs in 2010. As we enter the healthcare reform debate this year, it is important to understand how critical MTM is in helping to improve patient outcomes and help lower healthcare costs,” said NACDS president and CEO Steve Anderson. “During these challenging economic times, your neighborhood pharmacy can provide resources and counseling that can help patients to improve their health now to avoid high costs later, while not stretching their wallets. This is an important incremental step forward for MTM – a key component of the NACDS Principles of Healthcare Reform. NACDS will continue to work with Congress and the Administration to further improve and expand MTM efforts.”
NACDS did express concern about a provision in the letter that will eliminate reference-based pricing in Part D in 2010. Contrary to NACDS’ urging, CMS intends to move forward with this plan which will likely have a negative impact on generic prescription drug utilization. In an earlier letter to CMS, NACDS urged the agency to retain reference-based pricing.
The high generic utilization rate in Medicare Part D has been due, in part, to policies such as reference-based pricing. In addition, NACDS expressed concern that increased expenditures resulting from the elimination of reference-based pricing may be unfairly passed to all Medicare beneficiaries in the form of higher premiums, or to pharmacies in the form of reduced reimbursement.