April
28, 2017
PLAN UPDATES
New MTM Opportunities
Several new programs have launched across the
Midwest in recent weeks. Encourage your pharmacies to look for patients in
these groups:
- CareSource
Advantage Ohio H6396: Medicare plan covering CMRs,
TIPs and pharmacist-initiated services
- CareSource
Indiana Medicaid - HHW: Medicaid plan covering CMRs,
TIPs and pharmacist-initiated services
- CareSource
Indiana Medicaid - HIP: Medicaid plan covering CMRs,
TIPs and pharmacist-initiated services
- MHS-Healthy
Indiana Plan (HIP): Medicaid plan covering CMRs
and TIPs
- MHS-Hoosier
Care Connect (HCC): Medicaid plan (Indiana)
covering CMRs and TIPs
- Nebraska
Total Care: Medicaid plan covering CMRs and TIPs
PLATFORM UPDATES
CMR Delivery Method
Face-to-face? Telephonic? Prior authorization
needed? Pharmacies can now more readily see the CMR delivery methods available
for each patient. From the Patient List or MTM Opportunities queue, hover over
the CMR flag next to a patient's name to display accepted CMR delivery methods,
including whether or not a prior authorization code is required for a
telephonic CMR.
GENERAL UPDATES
Statin Use in Persons with
Diabetes
The Centers for Medicare and Medicaid
Services (CMS) have proposed that Statin Use in Persons with Diabetes
become a new Medicare Star measure. If confirmed, the measure will be included
in the 2019 Star Ratings (based on 2017 results), to rate the percentage of
diabetic patients age 40-75 who fill a statin.
In response to the proposed measure,
pharmacies can expect to see TIPs targeted at closing this gap in care. Tell
your pharmacies to watch for Needs Drug Therapy – Statin (Diabetes) TIPs
for Medicare patients. The TIP will prompt pharmacies to contact the patient's
prescriber to recommend initiating this important therapy. We will deploy a
large volume of these TIPs in the coming weeks, and they will likely become
common moving forward.
505 Market
Street, Suite 200, West Des Moines, IA 50266 | 877.237.0050
