Medication Management Therapy Available to Medicare Beneficiaries
About seven million Medicare beneficiaries who are enrolled in the program's drug plan will be eligible to receive medication management therapy under new rules that took effect in January, Kaiser Health News/USA Today reports.
Medication management therapy aims to detect medication-related problems in seniors and patients with disabilities.
About 25% of the nearly 28 million seniors and people with disabilities who receive Medicare drug coverage from insurance companies will be eligible for medication management under the new rules.
According to Medicare spokesperson Peter Ashkenaz, this represents about twice as many enrollees as 2009.
In 2006, Congress required health plans to offer medication management, but itÂ was unclear as to how the therapy should be provided.
Details of New Rules
Under the new rules, private insurers that offer drug coverage must automatically enroll members in medication management. Eligible members must have at least $3,000 annually in total drug costs, take several drugs and have chronic health conditions, such as diabetes, heart diseaseÂ or hypertension.
The new rules require insurance company representatives to ask patients about their medications and side effects. The program also requires the representatives -- usually pharmacists -- to report any issues to the patients' physicians, as well as any recommended medication or dosage changes. Patients may opt out of the program at any time.
Under the new rules, the service must include yearly medication reviews and quarterly reassessments. The reviews must be done in person, over the phone or via the Internet, and patients must receive a written summary (Jaffe, Kaiser Health News/USA Today, 3/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.