Leon Medical Centers Health Plans - Medication Therapy Management (MTMP)
Medication Therapy Management Program

We offer a Medication Therapy Management Program (MTMP) at no additional cost to members who have multiple medical conditions, who are taking many prescription drugs, and who have high drug costs. The necessary criteria for our 2018 MTM Program are as follows:

Member needs to have three (3) or more of the following chronic conditions: Osteoporosis, Arthritis, Chronic Heart Failure, Diabetes, Dyslipidemia, Hypertension

AND

Needs to be taking seven (7) or more of the following covered Part D drugs: ACE-Inhibitors, Alpha Blockers, Angiotensin II Receptor Blockers (ARBs), Antihyperlipidemics, Antihypertensives, Beta Blockers, Bisphosphonates, Calcium Channel Blockers, Diuretics, Insulins, Oral Hypoglycemics, Miscellaneous Metabolic Bone Disease Agents, Antihyperglycemic Agents

AND

Members that have annual prescription costs higher than one-fourth of a specified cost threshold in the previous three months. The annual threshold is determined by the Centers for Medicare & Medicaid Services and is set as greater than or equal to $3,967 for 2018.

All selected members based on the above criteria will be offered a comprehensive medication review (CMR) by a pharmacist at least annually, which will include a review of all medications including prescription, over-the-counter (OTC) medications, herbal therapies and dietary supplements. The service will be offered as an interactive person-to-person consultation with one of our Leon Medical Centers Health Plans Clinical Pharmacists. Following the medication review an individualized letter will be mailed to the member, which will include the personal medication record of all medications discussed and a medication action plan, if applicable. Letters will also be sent to providers as necessary after the CMR is completed to offer interventions to resolve medication-related problems or other opportunities to optimize medication use. In addition, a quarterly targeted medication review will be done automatically for all eligible members and interventions will be sent to the prescriber in a mailed letter.

Participation in the medication therapy management program is not a benefit, but a complimentary service offered to eligible members. All selected members will automatically be enrolled in the program unless they choose to not participate. Members will receive a welcome letter at the beginning of the year when they are identified as eligible. The letter will include the contact number to setup an appointment for a complimentary medication counseling session with a Leon Medical Centers Health Plan Clinical Pharmacist. The individualized medication review takes approximately 15 – 30 minutes.

If you would like further information regarding our MTM Program, you can contact the MTMP Department at 305-631-5086 or our Member Services Department toll free 1-866-393-5366, 8:00 AM to 8:00 PM (EST), 7 days a week.. TTY users should call toll free 711.

Personal Medication List