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Current Medication Pathfinder™ MTM Opportunities
The Washington State Health Care Authority (HCA) is seeking to have pharmacists perform Medication Therapy Management (MTM) for eligible enrollees within its Public Employees Health Plans (the Uniform Medical Plan and the Aetna Public Employees Plan of Washington). HCA has partnered with Clinical Support Services (CSS) to provide pharmacists with a web-based MTM program called Medication Pathfinder™. This technology will be provided free of charge to pharmacist members of the HCA MTM Network.
For the first phase of the project, HCA is focusing on poly-pharmacy (patients who are taking 10 or more unique prescription medications). Currently, there are estimated to be 8,500 to 10,000 HCA enrollees eligible to take part in this poly-pharmacy MTM project in Washington State.
Medication Pathfinder™ (MTMPath™) Program
Overview: MTMPath™ is a web-based program that assists pharmacists in providing Medication Therapy Management (MTM) services to patients. Launch Date: Early 2009
Location: Washington (Region 23)
Eligible Members: All pharmacists enrolled in the Medication Pathfinder Network (MPN) can use MTMPath™ to provide MTM services to any patient. There is no cost for patients who are eligible enrollees of the Washington State HCA program; for all other patients, there is an annual fee for participation.
The reimbursement rate for the HCA MTM program is $65.00 total. This includes pre-visit planning, a face-to-face MTM consultation, and post-visit follow-up.
CPT Code 99606 $15.00 Pre-Visit Preparation
CPT Code 99605 $35.00 MTM Consultation
CPT Code 99607 $15.00 Post-Visit Follow-Up
Pre-Visit Preparation: The pharmacist will make up to three attempts to contact the patient to arrange for consultation and engage the provider to collect patient data prior to MTM visit.
MTM Consultation: Face-to-face patient consultation provided by pharmacist; providing assessment and intervention, if required.
Post-Visit Follow-Up: The pharmacist will provide recommended changes to the provider and follow-up with the patient to assess compliance and adherence.
Become a Medication Pathfinder Network (MPN) Pharmacist:
To join the Medication Pathfinder Network and participate in the Washington State Health Care Authority (HCA) Program, complete the following forms:
If you wish to join the Medication Pathfinder Network and NOT participate in the HCA program, call 1-888-MTM-PATH (1-888-686-7284) or email info@medicationpathfinder.com.
Providing MTM services for HCA eligible enrollees:
· Pharmacists will utilize a poly-pharmacy protocol specially designed for the HCA program.
· CSS will contact all eligible HCA enrollees, via postal mail, to let them know about the objectives and goals of the MTM project. This letter will instruct patients to contact the enrolled pharmacist that they have been assigned to.
· Enrolled pharmacists will have 34 days upon being assigned an eligible enrollee make contact and perform the MTM consultation.
· The HCA pays 100% of the visit for eligible enrollees.
Using MTMPath™ to provide MTM services for patients who are not HCA enrollees:
The MTMPath™ web-based software can also be used by the enrolled pharmacist to perform MTM services on any patient, on behalf of any payer. As long as the pharmacist continues to participate in the HCA MTM program, the MTMPath™ software is free of charge. The software offers a wide array of therapeutic drug protocols, in addition to the HCA poly-pharmacy protocol.
If you wish to use MTMPath™ but do not want to participate in the HCA MTM program, there is a software license fee that is paid monthly and an annual per-patient storage fee. Please contact Medication Pathfinder for pricing information.
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