MTM bill introduced to Senate

Started by WVUPharm2007
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Don't laugh. I wrote this without any coffee and I kinda suck at writing even when caffeinated. In any event, I thought it might help some people as a primer.

Dear Senator,

My name is joetrisman 😉. I am a recent college graduate that is writing you out of concern for the financial situations occurring in the US today. Specifically, the rising cost of health care is a major concern of mine as I see the potential for health care to have the same collapse and subsequent economic repercussions that occurred in the housing market if action is not taken. Recently, a bill called, "Medication Therapy Management (MTM) Expanded Benefits Act" (S.3543 of the 111th) was introduced into the senate. This bill has the potential to save a great deal of money through an intelligent investment in health care. Furthermore, the model for this bill has already been implemented in North Carolina and showed 10 million dollars in savings over the first year with a little over 15,000 seniors participating. I implore you to look into this legislation, and if you feel that this could be as beneficial as I do, please vote for it.
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So, what do you guys think?

Will it pass? I mean, it's been proven to save money. I think it's really a win-win situation. Could it even potentially reduce the current cluster in many retail pharmacy settings?

Also, isn't MTM kind of, in a way, like a grocery store owner going through someone's cart and saying:

"You don't need the bread."
"You don't need the cheese."
"This steak is just unnecessary - toss that too."

Then concluding:

"Great, you have eggs."

Will retail pharmacies lose money over this in the long run?
 
Or, to potentially counter my own argument, it could open the door for more services by freeing up pharmacists who are currently arguably checking many unnecessary medications.

I think what pharmacy really needs is for pharmacists to be able to provide services, NOT just goods. I suppose this is why MTM would be a good thing.

Man, I just wish we could market ourselves to politicians like NPs, PAs, and MDs have. We need more of a presence in the political arena. Who knows...maybe I'll take a stab at it one day and make a difference in this profession!
 
jinga said:
Or, to potentially counter my own argument, it could open the door for more services by freeing up pharmacists who are currently arguably checking many unnecessary medications.

I think what pharmacy really needs is for pharmacists to be able to provide services, NOT just goods. I suppose this is why MTM would be a good thing.

Man, I just wish we could market ourselves to politicians like NPs, PAs, and MDs have. We need more of a presence in the political arena. Who knows...maybe I'll take a stab at it one day and make a difference in this profession!
Click to expand...

hire me to be a PR machine and represent pharmacy. I will get right in there. I personally know a bunch of senators (REAL TALK).

Anyways,

If you are an MD PharmD, can you bill someone for the office visit THEN bill them for the MTM as well? Basically double whammy?
 
Trankuil said:
This sounds like nothing but good news to me. Rep and Senator have been written 😀
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Thanks! I'd advise you to tell family, friends, and fellow pharmacy colleagues to do the same. 👍




Another article I came across that was pointing to the effectiveness of MTM (I was really unaware) at saving health care costs said this:

While there are many studies that have focused on MTM, one program with 186 patients through Blue Cross/Blue Shield of Minnesota found reductions in healthcare costs per person of 31.5%. The return on investment was $12.15 per $1.00 of MTM services provided.
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The original research article is available to those of you who have an AphA membership.
http://japha.metapress.com/openurl.asp?genre=article&eissn=1544-3450&volume=48&issue=2&spage=203

Just more fuel to the fire of what a good idea this is and as mentioned above, it being a win-win situation for all involved.
 
jinga said:
Also, isn't MTM kind of, in a way, like a grocery store owner going through someone's cart and saying:

"You don't need the bread."
"You don't need the cheese."
"This steak is just unnecessary - toss that too."

Then concluding:

"Great, you have eggs."

Will retail pharmacies lose money over this in the long run?
Click to expand...

I think a lot of it is more like:

"oh, instead of this white bread, you should buy high fiber whole wheat bread"

"This fancy yogart in your cart has the same ingredients as our generic yogart which is less than half the cost"

"I see you have some veggies, but you need to eat more"

Actually that last one is confusing b/c I was originally referring to increasing the dose of say, a statin or BP med, to get a patient to goal, but of course you would also counsel on diet
 
I would say the changes I make the most are adding drugs and increasing doses. Many people are undertreated despite having long med lists.
 
OH SWEET

so how do we as citizen of united states go about haggling our senators to pass this? Like do we got to write a letter or what? I want to make a personal initiative to have the bill passed.
 
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joetrisman said:
The name of the bill is Medication Therapy Management Expanded Benefits Act of 2010.

Quick link to write your congressmen:
https://writerep.house.gov/writerep/welcome.shtml

Rxlea, I think I'm more for taking the time to do this one than the other.
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Farcus said:
OH SWEET

so how do we as citizen of united states go about haggling our senators to pass this? Like do we got to write a letter or what? I want to make a personal initiative to have the bill passed.
Click to expand...
Here ya go.
 
Its Z said:
Immunization was a product distribution revenue with a slight procedural fee of administering a shot..which anyone can do.

Only pharmacists can provide MTM which is a fee for "cognitive" service. Night and Day.
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Not really. According to the bill posted, although pharmacists are mentioned specifically, the term 'other "qualified" health care providers' is also used in the text.

`(F) ACCESS REQUIREMENTS- ... PDP sponsor shall offer any willing pharmacy in its network and any other qualified health care provider the opportunity to provide such services.'.

a pharmacist or other qualified provider determines may benefit from medication therapy management services

If other qualified healthcare provider includes other non-physicians providers,
NPs, PAs, or other healthcare workers may step up and get the benefit. MTM may not be limited to pharmacists.
 
RNtoPharmD said:
Not really. According to the bill posted, although pharmacists are mentioned specifically, the term 'other "qualified" health care providers' is also used in the text.

`(F) ACCESS REQUIREMENTS- ... PDP sponsor shall offer any willing pharmacy in its network and any other qualified health care provider the opportunity to provide such services.'.

a pharmacist or other qualified provider determines may benefit from medication therapy management services

If other qualified healthcare provider includes other non-physicians providers,
NPs, PAs, or other healthcare workers may step up and get the benefit. MTM may not be limited to pharmacists.
Click to expand...

Though, that wasn't the point of my post, you're right. Other providers can provide this service...yet, I wouldn't trust your typical NPs and PAs to perform MTM.
 
Its Z said:
Though, that wasn't the point of my post, you're right. Other providers can provide this service...yet, I wouldn't trust your typical NPs and PAs to perform MTM.
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YOU may not trust them but guess what... they gonna do it and bill for it. too many hands in the cookie pot here.
 
PharmaTope said:
YOU may not trust them but guess what... they gonna do it and bill for it. too many hands in the cookie pot here.
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Again, you're missing an obvious point. NP and PA are already providers who can bill for their service. RPh can't except for product distribution. This bill if passed gets us in the door. You're a pessimist and we all know that. Pharmacist being able to bill for cognitive service may be the biggest change and event for our profession in a long time. And if you can't see that...then get your head out of your arse.
 
Its Z said:
Pharmacist being able to bill for cognitive service may be the biggest change and event for our profession in a long time. And if you can't see that...then get your head out of your arse.
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I hope so! It will make this seemingly endless battle I'm fighting about this worthwhile. 👍
 
I've been waiting for this for a long time. I'm currently doing rotations at the VA and love their set up. This is what I want to do as a pharmacist. I really hope this bill passes.
 
pharmaster said:
Btw, ItsZ and Mike I've been following you for a while and like the way you think...
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I've wondered this for years...but why the hell does everyone know my name?

Even on Xbox. My handle is ThaDruggist, but everyone on there calls me Mike. I don't recall ever telling any of them my real name...but there they are...Mike'n it up...

Somebody investigate the archives.
 
WVUPharm2007 said:
I've wondered this for years...but why the hell does everyone know my name?

Even on Xbox. My handle is ThaDruggist, but everyone on there calls me Mike. I don't recall ever telling any of them my real name...but there they are...Mike'n it up...

Somebody investigate the archives.
Click to expand...

I'll tell you how. I...see...you!
 
IrishHammer said:
Gotcha. Thanks for clearing that up.

I think I'm going to keep a close eye on this. I probably don't have the grades to get a residency, which severely hampers my chances at landing a hospital job. I'm not keen on retail, unless it's way out in the sticks, and even then it may only be a matter of time before conditions there go to hell in a handbasket as well. I'm only going to be graduating with about 60K in student loans, so I won't have to worry about selling my soul to pay off a big six figure bill and can look into various pharmacy avenues. Setting up some kind of MTM clinic sounds like a really nice idea.
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A residency is only going to help you get a hospital job if you want a highly specialized clinical job. Otherwise, it's nothing more than a way for a hospital to get away with paying a pharmacist a half salary for a year or two. JMHO and YMMV.
 
WVUPharm2007 said:
Joke's on you. My back yard smells of dog dung and a gay pedophile live across the street from me and stares in my yard all the time.

Haha. Enjoy being oogled/smelling dog doodoo.
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Ahhh....that wasn't a mud clump I stepped in. That wig doesn't fit him.
 
New Bills Lay Groundwork for Pharmacist Provider Status


7/14/2010
A bill that would provide coverage of clinical pharmacist practitioner services through Medicare Part B is an important first step, in utilizing pharmacists' unique expertise in managing the medication use system to help improve patient outcomes according to ASHP. The bill, HR 5389, the Medicare Clinical Pharmacist Practitioner Services Coverage Act, was introduced by Representative Martin Heinrich (D-NM).

Senators Kay Hagen (D-NC) and Al Franken (D-MN) have also recently introduced S. 3543, the Medication Therapy Management Expanded Benefits Act, which would increase patient access to pharmacists’ MTM services under Medicare Part D. Of particular interest to health system pharmacy, it would provide for a targeted medication review for Medicare enrollees who are experiencing a transition in care, such as a discharge from a hospital or other institutional setting.

ASHP is encouraged by both legislative proposals as well as provisions in the new health care reform law that provide for an MTM grant program. Collectively they form pieces of the puzzle in attaining recognition of pharmacists as providers of patient care services.
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http://www.ashp.org/import/news/NewsCapsules/article.aspx?id=358
 
Good to see a little more press on this. I actually got a letter back from my senator saying that he is actually on the committee that this bill is going to and appreciated hearing from a medical/pharmacy student. It actually wasnt a generic letter either, I was pretty impressed. I can put everything he said if anyone is interested.
 
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Trankuil said:
Good to see a little more press on this. I actually got a letter back from my senator saying that he is actually on the committee that this bill is going to and appreciated hearing from a medical/pharmacy student. It actually wasnt a generic letter either, I was pretty impressed. I can put everything he said if anyone is interested.
Click to expand...
I'd definitely be interested. Out of curiosity, what party was this guy from? My senators are both republican and I didn't hear squat back 🙁
 
It's true, pharmacists can get an NPI number! I got mine, do you have yours? You might just use it someday....

What is NPI?

Sign up now!

Its Z said:
Again, you're missing an obvious point. NP and PA are already providers who can bill for their service. RPh can't except for product distribution. This bill if passed gets us in the door. You're a pessimist and we all know that. Pharmacist being able to bill for cognitive service may be the biggest change and event for our profession in a long time. And if you can't see that...then get your head out of your arse.
Click to expand...
 
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