Sens. Pat Roberts and Kay Hagan introduce legislation to expand MTM access

WASHINGTON — U.S. Senators Pat Roberts, R-Kan. and Kay Hagan, D-N.C. on Thursday introduced legislation written to lower healthcare costs by helping more seniors better manage their prescriptions. The Medication Therapy Management Empowerment Act will allow seniors with any high-cost chronic illness to review all their medication and develop a plan of action with a pharmacist.

“Expanding this already successful program is a commonsense, fiscally responsible way to improve seniors’ health and reduce preventable trips to the hospital,” Hagan said. “MTM programs save lives and have already saved tens of millions of dollars in North Carolina alone. I urge my colleagues to join me and Senator Roberts to pass this bipartisan bill that will keep our seniors healthy and reduce healthcare costs.” 

“We have recognized the value of pharmacists in the health system for many years. They are especially valuable for our Kansas communities, and can sometimes be the only health provider in our rural towns.” Roberts added. “MTM is an important tool in the pharmacists tool box for many patients but which can be critical for those suffering from chronic conditions." 

Similar legislation was introduced in the House by Rep. Cathy McMorris Rodgers, R-Wash. last week. Both the National Association of Chain Drug Stores and the National Community Pharmacists Association are fully behind the bill, the associations stated.  

MTM involves pharmacists working with patients to review and monitor their medication plan to maximize its effectiveness and avoid potential health problems, ultimately helping to reduce costs in the long run. With approximately 1.5 million preventable adverse drug effects occurring every year as a result of medication errors, medication therapy programs can greatly improve patient safety, noted the NCPA in a press release issued Thursday evening. "For many Medicare patients, the challenges of coping with chronic conditions require an expert's consultation, and pharmacists are clinically-trained in helping ensure their patients are getting the best possible results for their health," noted NCPA CEO Douglas Hoey.

In a separate release, NACDS added that only 50% of patients take their medications properly as prescribed by their doctor, which costs the nation more than $290 billion annually in avoidable health spending annually, citing policy research group NEHI. “Pharmacists are widely trusted healthcare professionals with extensive education," stated Steve Anderson, NACDS president and CEO. "They are trained medication specialists who work collaboratively to help patients use medicines safely and stay healthy,” he said. “This legislation will go a long way in helping to further pharmacists’ ability to help improve patient health and make health care more affordable.”  

Currently Medicare Part D Plans are only required to offer MTM coverage plans to beneficiaries with multiple chronic conditions. The MTM Empowerment Act allows seniors with only one high cost chronic condition, such as diabetes, hypertension or asthma to access MTM services.

The bill includes safeguards to ensure that expanding access to MTM in Medicare will not increase spending but actually save money. Language in the bill stipulates that before seniors with one high-cost chronic condition may see a qualified provider for a comprehensive medication review, the Chief Actuary at the Centers for Medicare and Medicaid Services must certify that the program will lower spending. And, five years after implementation, the Chief Actuary must certify that the program actually did lower spending. Although all current evidence indicates that increased access to MTM services lowers overall health care spending for participating patients, if the Chief Actuary finds that the program did not lower spending, then the Secretary of Health and Human Services must review whether to continue the program for seniors with one high-cost chronic condition.