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Chapter 5: Legal Definitions and Requirements of MTM by State

Many states have adopted legal definitions of and requirements for design, implementation, and utilization of MTM services. However, not every state has passed legislation. When a state has not, it should be assumed that the state is utilizing CMS rules. As of 2020, each state’s definition and specific requirements are detailed below.

Alabama

This state has not adopted legal definitions of or requirements for MTM programs.

Alaska

This state has not adopted legal definitions of or requirements for MTM programs.

Arizona

Arizona sets forth the definition and rules regarding MTM in House Bill 2256:

HB 2256 includes medication therapy management services (MTM) under the Arizona Health Care Cost Containment System’s (AHCCCS) covered services subject to the availability of funds, and specifies the services MTM includes and the necessary qualifications of those who provide MTM.

  • Requires the [Arizona Health Care Cost Containment System (AHCCCS) to contract for the provision of MTM subject to the availability of monies.
  • States the MTM are to be provided by a licensed pharmacist.
  • Stipulates the MTM shall include the following pharmaceutical care services in order to optimize the therapeutic outcomes of the member’s medications:
    • Performing or obtaining necessary assessments of the member’s health status.
    • Formulating a medication treatment plan.
    • Monitoring and evaluating the member’s response to therapy, including safety effectiveness and outcomes.
    • Performing a comprehensive medication review to identify, resolve, and prevent medication related problems, including adverse drug events.
    • Documenting the care delivered and communicating essential information to the member’s other primary care providers.
    • Providing verbal education and training to enhance the member’s understanding and the appropriate use of the member’s medications.
    • Providing information, support services and resources to enhance the member’s adherence to the member’s therapeutic regimens.
    • Coordinating and integrating MTM within the broader health care management services being provided to the member.
  • Clarifies that this does not expand or modify the scope of practice of a pharmacist.
  • Requires the following of a pharmacist to be eligible for reimbursement for MTM:
    • Be actively licensed.
    • Have graduated from an accredited college of pharmacy and completed a structured and comprehensive education program, or have a drug therapy management agreement pursuant to rules adopted by the Arizona State Board of Pharmacy (Board), relating to the provision and documentation of pharmaceutical care management services that has both clinical and didactic elements.
    • Be practicing:
      • In an ambulatory care setting as part of a multidisciplinary team.
      • Pursuant to a structured patient care process that is offered in a private or semiprivate patient care community practice setting that is separate from the commercial business that also occurs in the setting.
      • In a management call center that is based in a college of pharmacy located in this state.
      • In a setting approved by the Board.
    • Use an electronic patient record system that meets standards prescribed by the AHCCCS.
  • Allows the AHCCCS to enroll individual pharmacists for the purposes of reimbursement for MTM.
  • Permits the AHCCCS to establish contact requirements between the pharmacist and member, including limiting the number of reimbursable consultations per member.
  • Requires the Director of the AHCCCS to evaluate the effectiveness of the MTM and submit a report to the Governor, Speaker of the House of Representatives, and President of the Senate on or before November 15, 2010.
  • Specifies that a copy of the report shall be provided to the Secretary of State and the Director of the Arizona State Library.
  • Mandates that the Director of the AHCCCS convene an advisory committee to solicit comments and make recommendations regarding the effectiveness, implementation, and administration of the MTM.
  • Stipulates that the advisory committee shall include:
    • A member of the Board.
    • A member of the Arizona Medical Board.
    • Two licensed physicians.
    • Two licensed pharmacists.
    • Two consumers of MTM.
    • Three members who have expertise in the area of MTM.
  • Clarifies that members of the advisory committee serve at the pleasure of the Director of the AHCCCS and are not eligible for compensation or reimbursement of expenses.

Arkansas

This state has not adopted legal definitions of or requirements for MTM programs.

California

This state has not adopted legal definitions of or requirements for MTM programs. The California State Board of Pharmacy documented proposals to amend California Business and Professions Code (BPC) 4052 in the March 16, 2005, Licensing Committee Report. However, since then, no statutes have been adopted.

Colorado

This state has not adopted legal definitions of or requirements for MTM programs.

Connecticut

This state has not adopted legal definitions of or requirements for MTM programs.

Delaware

This state has not adopted legal definitions of or requirements for MTM programs.

Florida

This state has not adopted legal definitions of or requirements for MTM programs.

Georgia

This state has not adopted legal definitions of or requirements for MTM programs.

Hawaii

This state has not adopted legal definitions of or requirements for MTM programs.

Idaho

Idaho Administrative Code 27.01.01.011.04 defines MTM:

MTM – Medication Therapy Management. A distinct service or group of services that optimize therapeutic outcomes for individual patients. MTM services are independent of, but can occur in conjunction with, the provision or administration of a drug or a device and encompass a broad range of activities and responsibilities. The MTM service model in pharmacy practice includes the following five core elements:

  1. Medication therapy review;
  2. Personal medication record;
  3. Medication-related action plan;
  4. Intervention of referral, or both;
  5. Documentation and follow-up.

Illinois

The Illinois Public Act 096-0673 contains the following definitions and requirements:

“Medication therapy management services” means a distinct service or group of services offered by licensed pharmacists, physicians licensed to practice medicine in all its branches, advanced practice nurses authorized in a written agreement with a physician licensed to practice medicine in all its branches, or physician assistants authorized in guidelines by a supervising physician that optimize therapeutic outcomes for individual patients through improved medication use. In a retail or other non-hospital pharmacy, medication therapy management services shall consist of the evaluation of prescription drug orders and patient medication records to resolve conflicts with the following:

(1) known allergies;

(2) drug or potential therapy contraindications;

(3) reasonable dose, duration of use, and route of administration, taking into consideration factors such as age, gender, and contraindications;

(4) reasonable directions for use;

(5) potential or actual adverse drug reactions;

(6) drug-drug interactions;

(7) drug-food interactions;

(8) drug-disease contraindications;

(9) identification of therapeutic duplication;

(10) patient laboratory values when authorized and available;

(11) proper utilization (including over or under utilization) and optimum therapeutic outcomes; and

(12) drug abuse and misuse.

“Medication therapy management services” includes the following:

(1) documenting the services delivered and communicating the information provided to patients’ prescribers within an appropriate time frame, not to exceed 48 hours;

(2) providing patient counseling designed to enhance a patient’s understanding and the appropriate use of his or her medications; and

(3) providing information, support services, and resources designed to enhance a patient’s adherence with his or her prescribed therapeutic regimens.

“Medication therapy management services” may also include patient care functions authorized by a physician licensed to practice medicine in all its branches for his or her identified patient or groups of patients under specified conditions or limitations in a standing order from the physician.

“Medication therapy management services” in a licensed hospital may also include the following:

(1) reviewing assessments of the patient’s health status; and

(2) following protocols of a hospital pharmacy and therapeutics committee with respect to the fulfillment of medication orders.

“Pharmacist care” means the provision by a pharmacist of medication therapy management services, with or without the dispensing of drugs or devices, intended to achieve outcomes that improve patient health, quality of life, and comfort and enhance patient safety.

Indiana

The following definitions and requirements are found in Indiana Code Title 25. Professions and Occupations § 25-26-13-2:

“Medication therapy management” means a distinct service or group of services that optimize therapeutic outcomes for individuals that are independent of, but may occur in conjunction with, the provision of a medication or medical device. The term includes the following services:

(1) Performing or obtaining assessments of an individual’s health status.

(2) Formulating a medication treatment plan.

(3) Selecting, initiating, modifying, or administering medication therapy.

(4) Monitoring and evaluating an individual’s response to therapy, including safety and effectiveness.

(5) Performing a comprehensive medication review to identify, resolve, and prevent medication related problems, including adverse drug events.

(6) Documenting the care delivered and communicating essential information to the patient’s other health care providers.

(7) Providing education and training designed to enhance patient understanding and appropriate use of the individual’s medications.

(8) Providing information and support services and resources designed to enhance patient adherence with the individual’s therapeutic regimens, including medication synchronization.

(9) Coordinating and integrating medication therapy management services within the broader health care services being provided to an individual.

(10) Providing other patient care services allowable by law.

“The practice of pharmacy” or “the practice of the profession of pharmacy” means a patient oriented health care profession in which pharmacists interact with and counsel patients and with other health care professionals concerning drugs and devices used to enhance patients’ wellness, prevent illness, and optimize the outcome of a drug or device, by accepting responsibility for performing or supervising a pharmacist intern or an unlicensed person under section 18.5 of this chapter to do the following acts, services, and operations:

(1) The offering of or performing of those acts, service operations, or transactions incidental to the interpretation, evaluation, and implementation of prescriptions or drug orders.

(2) The compounding, labeling, administering, dispensing, or selling of drugs and devices, including radioactive substances, whether dispensed under a practitioner’s prescription or drug order or sold or given directly to the ultimate consumer.

(3) The proper and safe storage and distribution of drugs and devices.

(4) The maintenance of proper records of the receipt, storage, sale, and dispensing of drugs and devices.

(5) Counseling, advising, and educating patients, patients’ caregivers, and health care providers and professionals, as necessary, as to the contents, therapeutic values, uses, significant problems, risks, and appropriate manner of use of drugs and devices.

(6) Assessing, recording, and reporting events related to the use of drugs or devices.

(7) Provision of the professional acts, professional decisions, and professional services necessary to maintain all areas of a patient’s pharmacy related care as specifically authorized to a pharmacist under this article.

(8) Provision of medication therapy management.

Iowa

This state has not adopted legal definitions of or requirements for MTM programs.

Kansas

This state has not adopted legal definitions of or requirements for MTM programs.

Kentucky

This state has not adopted legal definitions of or requirements for MTM programs.

Louisiana

Revised Statutes § 46:153.3.1 sets forth the following legal definitions and requirements:

  1. For the purposes of this Section, the following terms shall have the following meanings:

(1) “Medicaid medication therapy management” may include the review or modification of medication therapy regimens of patients by a licensed pharmacist, in collaboration with a primary health care provider, and may include the provision of the following services to optimize the therapeutic outcomes of a patient’s medication:

(a) Conducting a medication therapy review with the patient to identify, resolve, and prevent medication-related problems, including adverse drug events.

(b) Working with the patient to develop a personal medication record that contains all prescribed and nonprescription drugs, herbal products, and dietary supplements taken by the patients.

(c) Working with the patient to develop a medication-related action plan for the patient to use in collaborative medication self-management.

(d) Providing consultative services for the patient, intervening to address medication-related issues, and when the pharmacist believes it will be beneficial to the patient’s health, referring the patient to his regular health care provider for evaluation and additional referrals.

(e) Performing all necessary follow-up medication therapy management services for the maintenance and support of the patient, as recommended by the primary health care provider or specialist.

(f) Maintaining all necessary documentation, including the following and any other records required for compliance with state and federal laws and regulations requiring maintenance of patient records:

(i) Patient demographics and basic identifying information.

(ii) Pertinent patient-reported subjective information.

(iii) Objective observations regarding known allergies, diseases, conditions, laboratory results, vital signs, diagnostic signs, physical examination results, and a review of internal systems.

(iv) An assessment of medication-related problems.

(v) A care plan.

(vi) Any collaborative communications with the primary health care provider and other health care professionals.

(vii) Patient-centric lists of actions to be followed to track progress is medication self-management.

(viii) Any relevant transition plan or scheduling of follow-up visits.

(ix) Billing information including level of patient care, level of complexity, and charges.

(2) “Medication therapy review” may include the following:

(a) Interviewing the patient to gather data, including demographic information, general health and activity status, medical history, medication history, immunization history and to collect the patient’s personal assessment about his or her disease or condition and medication use.

(b) In collaboration with a health care provider, performing necessary clinical assessments of the patient’s health status, including current or previous diseases or conditions.

(c) Assessing patient values, preferences, quality of life, goals of therapy, cultural issues, education level, language barriers, literacy level, and other characteristics affecting the patient’s communication skills that could affect patient outcomes.

(d) Assessing, identifying, prioritizing, and developing a plan for resolving medication-related problems related to the clinical appropriateness of each medication, the appropriateness of the dosage of each medication, including considerations of indications, contraindications, and potential adverse effects, adherence to regimen, untreated diseases or conditions, medication costs, and provider access considerations.

(e) Providing education and training on the appropriate use of medications and monitoring devices.

(f) Coaching patients to manage their own medications.

(g) Evaluating the patient’s ability to detect symptoms that could be attributed to adverse reactions or interactions from medications.

(h) Interpreting, monitoring, and assessing a patient’s laboratory results as ordered by the health care provider.

(i) Monitoring and evaluating the patient’s responses to his or her medication therapies, including the safety and effectiveness of those therapies.

(j) Communicating appropriate information to the primary health care provider or other health care professionals, including consultation on the selection of medications, suggestions to address identified medication problems, updates on the patient’s progress, and recommended follow-up care.

  1. The Department of Health and Hospitals shall consider implementing a medication therapy management program which may provide certain medication therapy management services to qualified Medicaid recipients.
  2. The department shall consider the following provisions when analyzing whether to implement a Medicaid medication therapy management program:

(1) Eligibility of patients to receive medication therapy management services under the program, using standards such as minimum number of medications, multiple chronic medical conditions, and likelihood of incurring high drug costs.

(2) Requirements for pharmacists to receive reimbursement for medication therapy management services, which may include at a minimum that:

(a) The pharmacist providing the services shall hold a valid and current license issued by the Louisiana Board of Pharmacy.

(b) The pharmacist shall currently practice in a community pharmacy, ambulatory, long-term, or home health care setting.

(c) The pharmacist shall develop a structured patient care process.

(d) The pharmacist shall maintain appropriate documentation that meets the department’s requirements for outcomes analysis and patient care.

(3) Amount of reimbursement to pharmacists for the provision of medication therapy management services.

(4) Requirements for patient meeting criteria.

(5) Provisions for referrals and coordination with primary care providers.

(6) Limitations on the provision of medication therapy management services.

  1. Nothing in this Section shall be construed to give pharmacists who are performing medication therapy management services the authority to write prescriptions or change, alter, or adjust prescription medication without the order of a physician, exercise independent medical judgment, diagnose, request laboratory tests, provide patient care independently, or otherwise engage in the practice of medicine.
  2. The department may promulgate and publish rules and regulations pursuant to this Section in accordance with the Administrative Procedure Act if the department elects to implement a Medicaid medication therapy management program.

Maine

Sec. 2. 24-A MRSA §4319 establishes comprehensive definitions and requirements for MTM services. It was enacted in 2012 and establishes coverage requirements, reimbursement, identification of targeted patients, and an exhaustive list of how to provide MTM and who can provide it. The statute is available here (http://www.mainelegislature.org/legis/bills/bills_125th/billtexts/SP019201.asp).

Maryland

This state has not adopted legal definitions of or requirements for MTM programs.

Massachusetts

This state has not adopted legal definitions of or requirements for MTM programs.

Michigan

This state has not adopted legal definitions of or requirements for MTM programs.

Minnesota

Minnesota Statute 62Q.676 does not define MTM, but establishes requirements that apply to pharmacy benefit managers:

A pharmacy benefit manager that provides prescription drug services must make available medication therapy management services for enrollees taking four or more prescriptions to treat or prevent two or more chronic medical conditions. For purposes of this section, “medication therapy management” means the provision of the following pharmaceutical care services by, or under the supervision of, a licensed pharmacist to optimize the therapeutic outcomes of the patient’s medications:

(1) performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events;

(2) communicating essential information to the patient’s other primary care providers; and

(3) providing verbal education and training designed to enhance patient understanding and appropriate use of the patient’s medications.

Mississippi

This state has not adopted legal definitions of or requirements for MTM programs.

Missouri

This state has not adopted legal definitions of or requirements for MTM programs.

Montana

This state has not adopted legal definitions of or requirements for MTM programs.

Nebraska

This state has not adopted legal definitions of or requirements for MTM programs.

Nevada

This state has not adopted legal definitions of or requirements for MTM programs.

New Hampshire

New Hampshire Title XXX, Occupations and Professions, Section 318:1, XXVIII defines MTM on its own and while utilizing a Collaborative Practice Agreement:

“Medication therapy management” means the review of medication therapy regimens of patients by a pharmacist for the purpose of evaluating and rendering advice to a practitioner, or evaluating and modifying the medication regimen in accordance with the collaborative pharmacy practice agreement. Decisions involving medication therapy management shall be made in the best interest of the patient. Medication therapy management shall be limited to:

(a) Implementing, modifying, and managing medication therapy according to the terms of the collaborative pharmacy practice agreement;

(b) Collecting and reviewing patient histories within the context of needs for pharmacy practice;

(c) Obtaining and checking vital signs, such as pulse, temperature, blood pressure, and respiration;

(d) Ordering laboratory tests as specifically set out in the collaborative pharmacy practice agreement between the pharmacist and the attending practitioner that are specific to the medication or protocol;

(e) Formulating a medication treatment plan that will be shared with the patient’s attending practitioner;

(f) Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness;

(g) Performing a comprehensive medication review, in conjunction with the attending practitioner, to identify, resolve, and prevent medication-related problems, including adverse drug events;

(h) Documenting the care delivered and, if applicable, communicating essential information to the patient’s other health care providers; and

(i) Providing education and training designed to enhance patient understanding and the appropriate use of his or her medications.

New Jersey

This state has not adopted legal definitions of or requirements for MTM programs.

New Mexico

This state has not adopted legal definitions of or requirements for MTM programs.

New York

This state has not adopted legal definitions of or requirements for MTM programs.

North Carolina

MTM is defined in 21 NCAC 46 .1317(20):

Medication Therapy Management Services and Related Functions. Services and functions included in the practice of pharmacy as part of monitoring, recording and reporting drug therapy and device usage.

North Dakota

This state has not adopted legal definitions of or requirements for MTM programs.

Ohio

In Ohio, the Ohio Administrative Code 4729:5-12-01 contains definitions relevant to MTM:

(A) “Personal supervision” or “direct supervision” means a pharmacist shall be physically present in the pharmacy, or in the area where the practice of pharmacy is occurring, and provide personal review and approval of all professional activities.

(B) “Medication therapy management” or “MTM” means:

(1) A distinct service or group of services that is intended to optimize the therapeutic outcomes of a patient. Medication therapy management can be an independent service provided by a pharmacist or pharmacy intern under the direct supervision of a pharmacist or can be in conjunction with the dispensing of a dangerous drug with the objectives of:

(a) Enhancing appropriate medication use;

(b) Improving medication adherence;

(c) Increasing detection of adverse drug events;

(d) Improving collaboration between a prescriber and pharmacist; and

(e) Improving outcomes.

(2) Medication therapy management may only be performed by the following:

(a) An Ohio licensed pharmacist;

(b) An Ohio licensed pharmacy intern practicing in this state under the direct supervision of a pharmacist; and

(c) A pharmacist or pharmacy intern practicing in another state in accordance with that state’s laws and rules.

Ohio Administration Code 4729:5-12-02 contains MTM requirements:

(A) A pharmacist or pharmacy intern under the direct supervision of a pharmacist that provides medication therapy management services shall practice at a location that complies with one of the following:

(1) If the person or entity solely performs medication therapy management in this state or to residents of this state, the location shall be licensed as a limited category II terminal distributor of dangerous drugs license with a medication therapy management classification; or

(2) If the person or entity engages in the sale of dangerous drugs, the location is appropriately licensed as a terminal distributor of dangerous drugs.

(B) A non-resident provider of medication therapy management shall obtain the appropriate licensure in accordance with paragraph (A) of this rule.

(C) The number of interns engaged in the practice of medication therapy management at any time is limited to not more than two for each pharmacist on duty unless otherwise approved by the board.

(D) A pharmacist or pharmacy intern under the direct supervision of a pharmacist that provides medication therapy management services shall ensure that they are provided according to the individual needs of a patient and may include the following:

(1) Performing or otherwise obtaining a patient’s health status assessment;

(2) Developing a medication treatment plan for monitoring and evaluating a patient’s response to therapy;

(3) Monitoring the safety and effectiveness of the medication therapy;

(4) Performing a medication review to identify, prevent or resolve medication related problems;

(5) Providing education and training to a patient or a patient’s agent on the use or administration of the medication;

(6) Documenting the delivery of care, communications with other involved healthcare providers and other appropriate documentation and records pursuant to paragraph (E) of this rule;

(7) Providing necessary services to enhance a patient’s adherence with the therapeutic regimen;

(8) Integrating medication therapy management services within the overall health management plan for a patient;

(9) Providing for the safe custody and security of all records and compliance with all applicable federal and state laws, rules and regulations concerning the security and privacy of patient information; and

(10) Any other activity as determined by the board.

(E) All records relating to medication therapy management service shall:

(1) Provide accountability and an audit trail; and

(2) Be uniformly maintained for a period of three years and shall be made readily retrievable.

Oklahoma

This state has not adopted legal definitions of or requirements for MTM programs.

Oregon

Oregon Administrative Rule (OAR) 855-019-0250 contains the following definitions and requirements:

(1) Medication Therapy Management (MTM) is a distinct service or group of services that is intended to optimize the therapeutic outcomes of a patient. Medication Therapy Management can be an independent service provided by a pharmacist or can be in conjunction with the provision of a medication product with the objectives of:

(a) Enhancing appropriate medication use;

(b) Improving medication adherence;

(c) Increasing detection of adverse drug events;

(d) Improving collaboration between practitioner and pharmacist; and

(e) Improving outcomes.

(2) A pharmacist that provides MTM services shall ensure that they are provided according to the individual needs of the patient and may include but are not limited to the following:

(a) Performing or otherwise obtaining the patient’s health status assessment;

(b) Developing a medication treatment plan for monitoring and evaluating the patient’s response to therapy;

(c) Monitoring the safety and effectiveness of the medication therapy;

(d) Selecting, initiating, modifying or administering medication therapy in consultation with the practitioner where appropriate;

(e) Performing a medication review to identify, prevent or resolve medication related problems;

(f) Monitoring the patient for adverse drug events;

(g) Providing education and training to the patient or the patient’s agent on the use or administration of the medication;

(h) Documenting the delivery of care, communications with other involved healthcare providers and other appropriate documentation and records as required. Such records shall:

(A) Provide accountability and an audit trail; and

(B) Be preserved for at least three years and be made available to the Board upon request except that when records are maintained by an outside contractor, the contract must specify that the records be retained by the contractor and made available to the Board for at least three years.

(i) Providing necessary services to enhance the patient’s adherence with the therapeutic regimen;

(j) Integrating the medication therapy management services within the overall health management plan for the patient; and

(k) Providing for the safe custody and security of all records and compliance with all relevant federal and state laws and regulations concerning the security and privacy of patient information.

Pennsylvania

This state has not adopted legal definitions of or requirements for MTM programs.

Rhode Island

This state has not adopted legal definitions of or requirements for MTM programs.

South Carolina

This state has not adopted legal definitions of or requirements for MTM programs.

South Dakota

This state has not adopted legal definitions of or requirements for MTM programs.

Tennessee

Tennessee code 63-10-204(23) defines MTM as:

Medication therapy management program means the distinct service or group of services that optimize therapeutic outcomes for individual patients. Medication therapy management services are independent of but can occur in conjunction with the provision of a medication product;

Texas

In January 2019, the Texas State Board of Pharmacy (TSBP) proposed rule changes to 22 TC §291.153 that would define and regulate MTM. The Texas Medical Association (TMA) responded in opposition to the proposed rule changes, and the TSBP withdrew the proposal. To date, Texas has not adopted legal definitions of or requirements for MTM programs.

Utah

This state has not adopted legal definitions of or requirements for MTM programs.

Vermont

04-030-230 Vt. Code R. § 16-16.1(c) defines MTM as:

“Medication Therapy Management” as used in this section means a distinct service or group of services that optimize therapeutic outcomes for individual patients. Medication Therapy Management services are independent of, but can occur in conjunction with, the provision of a medication or a medical device.

Virginia

This state has not adopted legal definitions of or requirements for MTM programs.

Washington

This state has not adopted legal definitions of or requirements for MTM programs.

West Virginia

WV Code §30-5-4(42) defined MTM as follows:

“Medication therapy management” is a distinct service or group of services that optimize medication therapeutic outcomes for individual patients. Medication therapy management services are independent of, but can occur in conjunction with, the provision of a medication or a medical device. Medication therapy management encompasses a broad range of professional activities and responsibilities within the licensed pharmacist’s scope of practice.

These services may include the following, according to the individual needs of the patient:

(A) Performing or obtaining necessary assessments of the patient’s health status pertinent to medication therapy management;

(B) Optimize medication use, performing medication therapy, and formulating recommendations for patient medication care plans;

(C) Developing therapeutic recommendations, to resolve medication related problems;

(D) Monitoring and evaluating the patient’s response to medication therapy, including safety and effectiveness;

(E) Performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events;

(F) Documenting the care delivered and communicating essential information to the patient’s primary care providers;

(G) Providing verbal education and training designed to enhance patient understanding and appropriate use of his or her medications;

(H) Providing information, support services and resources designed to enhance patient adherence with his or her medication therapeutic regimens;

(I) Coordinating and integrating medication therapy management services within the broader health care management services being provided to the patient; and

(J) Such other patient care services as may be allowed by law.

Wisconsin

This state has not adopted legal definitions of or requirements for MTM programs.

Wyoming

In Wyoming, 059-2 Wyo. Code R. § 2-4(z) defines MTM as:

“Medication therapy management” (also known as “drug therapy management”) is a distinct service or group of services that optimize therapeutic outcomes for individual patients. Medical therapy management (MTM) services are independent of, but can occur in conjunction with, the provision of a medication or a medical device MTM encompasses a broad range of professional activities and responsibilities within the licensed pharmacist’s scope of practice. MTM services may be performed without a collaborative practice agreement. These services may include, but are not limited to, the following, according to the individual needs of the patient:

(i) Performing or obtaining necessary assessments of the patient’s health status;

(ii) Formulating a medication treatment plan;

(iii) Selecting, initiating, modifying or administering medication therapy;

(iv) Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness;

(v) Performing a comprehensive medication review to identify, resolve and prevent medication-related problems, including adverse drug events;

(vi) Documenting the care delivered and communicating essential information to the patient’s other primary care providers;

(vii) Providing verbal education and training designed to enhance patient understanding and appropriate use of his or her medications;

(viii) Providing information, support services and resources designed to enhance patient adherence with his or her therapeutic regimens;

(ix) Coordinating and integrating MTM services within the broader health care management services being provided to the patient;

(x) Such other patient care services as may be allowed by law; or

(xi) Ordering, or performing laboratory assessments, and evaluating the response of the patient to therapy, as it directly relates to MTM, provided:

(A) The pharmacy or service is certified by the US Department of Health and Human Services, as a clinical laboratory under the Clinical Laboratory Improvement Amendments (CLIA); or

(B) The tests do not otherwise require a physician’s order and the pharmacy or service has obtained a CLIA Certificate of Waiver from the US Department of Health and Human Services; and

(C) The pharmacist is qualified to direct the laboratory.

About this chapter

Cite this chapter as: 

National Board of Medication Therapy Management, Thomas, D. & Tran, J. (2020, September 1). Medication Therapy Management. National Board of Medication Therapy Management. https://www.nbmtm.org/mtm-reference/medication-therapy-management/

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