Mirixa is dedicated to bringing pharmacies additional opportunities to engage more patients and deliver measurable results through our Medication Therapy Management programs. On July 28th, the Aetna 30-90 Day Conversion Program will begin.  

Reimbursement for the Aetna 30-90 Day Conversion Program is $25.00 for each case served in accordance with the Program Services Description (PSD) document. Cases may be served either face to face or telephonically. The PSD document will become available on the MirixaProSM platform on July 21st for your pharmacists to access.  

PROGRAM OVERVIEW

This overview summarizes, and describes the services to be provided to eligible patients by pharmacists under the Aetna 30-day – 90-day Conversion Program (Program). The goal of the Program is to promote patient adherence by making patients aware that a medication they are currently taking with a 30-day supply is available to be filled with a 90-day supply and by coordinating with their prescribers, when applicable, to convert those medications dispensed with a 30-day supply to a 90-day supply. Pharmacists will be presented cases in which the patient is taking at least one medication from any of the following classes of medications: Statins, ACE inhibitors (ACE-I), Angiotensin II Receptor Blockers (ARB) Direct Renin Inhibitors (DRI) and, Diabetic medications; and the medication was dispensed for a 30-day supply.

The pharmacist will administer the service via telephone or by meeting face to face with the patient, or the patient’s caregiver when appropriate. The pharmacist must advise patients and prescribers in the Program that their participation is voluntary; any recommendations made by the pharmacist are not intended to substitute for the judgment of the prescriber; prescribers are not obligated to prescribe any medications for patients; and patients are not obligated to obtain new 90-day supplies of their medications. Tasks associated with this service may be delegated to support personnel when legal and regulatory guidelines applicable to the pharmacist’s practice permit such delegation.

Required elements of this Program are:

• Patient Meeting: The pharmacist meets with the patient (or caregiver, as appropriate) face to face or by telephone.
• Alert Resolution: The pharmacist resolves all the Alerts generated by the MirixaPro℠ platform and documents resolution reason and appropriate recommendation to a prescriber.
• Prescriber outreach: If the patient accepts the pharmacist’s recommendation to switch from a 30-day supply of a medication to a 90-day supply, the pharmacist forwards his/her recommendation to the prescriber if a prescriber’s action is needed.
• Attestation and Authorization: The pharmacist reviews the attestations he/she provided while performing the tasks listed above, documents the type of delivery and service date, and submits the service for billing. (The service date is the date on which the pharmacist met with the patient, not the date the pharmacist closes the case.)

Please download the attached PDF for more information.