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10/5/2004
Press Release

ASHP Urges CMS to Take Stronger Hand in Assuring Appropriate Medication Therapy for Medicare Patients

The American Society of Health-System Pharmacists (ASHP) is strongly urging the Bush Administration to offer clear guidance to Medicare prescription drug plans on how to establish and conduct medication therapy management programs (MTMPs) in order to ensure an effective Part D benefit for patients.  In sharp contrast with the Administration's proposal, ASHP believes that the federal government must specify minimum requirements for MTMPs to ensure that Medicare patients who are on high-risk therapies receive proper care.

In comments submitted yesterday to the Centers for Medicare & Medicaid Services (CMS) on its proposed rule to implement the new Medicare prescription drug benefit, ASHP outlines vital steps CMS should take to provide beneficiaries with clinically appropriate, safe, and cost-effective drug therapy.

Under the new Medicare law, health plans must provide MTMPs for eligible beneficiaries. ASHP is urging CMS to maintain tighter oversight and provide a minimum framework upon which plan sponsors can build an MTMP. ASHP believes that this is a vital step to ensure beneficiary access and enhance continuity of care.

ASHP recommends that CMS:

  • Establish minimum criteria to define which beneficiaries are eligible for MTMPs,
  • Ensure such programs are run by skilled, well-trained pharmacists (or other health care providers with equal education in pharmacology and therapeutics),
  • Convene an expert panel to review public comments on MTMPs and develop one or more model programs that would best serve Medicare patients,  and
  • Base payments for MTMP services on the time and resources used by providers.  ASHP also urges CMS to integrate the value of these services into the Current Procedural Terminology (CPT) coding process.

ASHP also expanded on its recent comments to the U.S. Pharmacopeia and CMS on the Model Guidelines for Formulary Development by recommending that CMS:

  • Establish a pharmacy and therapeutics committee to continually review the formulary to ensure beneficiaries receive clinically appropriate, safe, and cost-effective drug therapy.  ASHP recommends that 40 percent of the committee members be independent of plan sponsors and drug product manufacturers.
  • Recommend that prescription drug plans use appropriate references such as ASHP’s Best Practices for Health-System Pharmacy guidelines and its AHFS Drug Information compendia when developing their formularies.

ASHP commented on a number of other provisions in the proposed rule, including quality assurance, drug utilization management, access standards, dispensing fees, and electronic prescribing. The full comments can be found on-line at http://www.ashp.org/pr/cms10-04.pdf.

For more than 60 years, ASHP has helped pharmacists who practice in hospitals and health systems improve medication use and enhance patient safety. The Society’s 30,000 members include pharmacists and pharmacy technicians who practice in inpatient, outpatient, home-care, and long-term-care settings, as well as pharmacy students. For more information about the wide array of ASHP activities and the many ways in which pharmacists help people make the best use of medicines, visit ASHP's Web site, www.ashp.org, or its consumer Web site, www.SafeMedication.com.

 

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