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INSTRUCTIONS FOR IMPLEMENTING THE STANDARDIZED FORMAT

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Changes included in this revision (08/15/2012) apply to cognitively impaired beneficiaries and to the Spanish translation of the Standardized Format:

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  1. Recommendations for using the Standardized Format for summaries of CMRs performed for cognitively impaired beneficiaries are described on pages 702-704 and 708.

    1. The requirement to offer CMRs to all beneficiaries, regardless of setting, is described on page 702.

    2. Content for the Inside Address and the Additional Space fields are described on page 703.

    3. Use of the carbon-copy field is described on page 704.

    4. Adding the name of the person who represented the beneficiary as a data source in the PML is described on page 27.

  2. Changes related to the Spanish translation appear in on page 730.

    1. Added an accent to the word "como" in second paragraph of the Cover Letter.

    2. Adjusted the text to properly display small caps for the Titles and Date Prepared fields in the Medication Action Plan and Personal Medication List.

    3. Deleted the second occurrence of the word "la" in the third bullet of the instructions in the Personal Medication List.

    4. Added additional spacing within the instruction section in the Personal Medication List.

    5. Changed both words to title case in "Otra Information" in the Personal Medication List.

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INTRODUCTION

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The Medicare Part D Medication Therapy Management (MTM) Program Standardized Format (Format) is a written summary of a comprehensive medication review (CMR). A CMR is an interactive, person-to-person or telehealth medication review and consultation of a beneficiary's medications (including prescriptions, over-the-counter (OTC) medications, herbal therapies, and dietary supplements) by a pharmacist or qualified provider that is intended to aid in assessing medication therapy and optimizing patient outcomes. Part D sponsors must, at a minimum, offer a CMR annually for targeted beneficiaries and provide written summaries. The summaries must comply with requirements as specified by CMS for the Format as of January 1, 2013.

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BACKGROUND

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Section 10328 of the Affordable Care Act amended section 1860D-4(c)(2)(ii) of the Act to require prescription drug plan sponsors to offer, at a minimum, an annual comprehensive medication review (CMR) that may be furnished person-to-person or via telehealth technologies. The CMR must include a review of the individual's medications, which may result in the creation of a recommended medication action plan with a written or printed summary of the results of the review provided to the targeted individual. The Act further required the development of a standardized format for the action plan and summary. Standardization of the format of these documents is expected to improve the quality of the MTM program services and provide consistency in beneficiary communications across differing Medicare Part D programs.

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As noted above, a CMR is an interactive, person-to-person or telehealth medication review and consultation of a beneficiary's medications (including prescriptions, over-the-counter (OTC) medications, herbal therapies, and dietary supplements) by a pharmacist or qualified provider that is intended ...

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