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Medication Therapy Management

IEHP offers Medication Therapy Management (MTM) to qualified Members. MTM is a term to describe a broad range of services offered by Pharmacists on our health care team. 
 

The IEHP Clinical Pharmacy Team reviews the Members’ medicines, making sure they’re taking the right ones for their health conditions. If you are a Provider for IEHP Members who qualify for the MTM Program, you can let them know to look out for a letter from us. They will be enrolled automatically—unless they opt-out. MTM is offered to Members at no additional cost.

MTM Logo

IEHP's MTM services include these core elements:

  • Medication therapy reviews
  • Medication education
  • Disease management

A team of Pharmacists and Doctors developed these MTM services to help provide better prescription drug coverage for our Members. For example, MTM also helps identify possible medication errors.

Medicare MTM Program

This is a free program under Medicare Part D for IEHP DualChoice Members who have multiple medical conditions, take many prescription drugs, and have high drug costs to assist with better medication management and overall health.

IEHP DualChoice Members’ enrollment includes a yearly comprehensive medication review (CMR) and regular targeted medication review (TMR) services throughout the year. MTM services include:

Comprehensive Medication Review (CMR)

An IEHP Clinical Pharmacist will provide an annual comprehensive review of the IEHP DualChoice Member’s medications over the phone. The Pharmacist will review IEHP DualChoice Member’s medications and make clinical recommendations to IEHP DualChoice Members and Providers.

Targeted Medication Review (TMR)

The IEHP Clinical Pharmacy Team will also offer TMRs throughout the year by reviewing issues with the participating IEHP DualChoice Member’s medicines. The team will perform TMRs for all enrolled beneficiaries every three months. The beneficiary may get TMR recommendations by mail and their Primary Care Provider may receive recommendations by fax—if the IEHP Clinical Pharmacy Team deems it necessary.

For more information, IEHP DualChoice members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. 

Medicare MTM Program services may have limited eligibility criteria. They are available for the following conditions:

1. The IEHP DualChoice Member has a minimum of three (3) disease states:

  • Bone Disease/Arthritis-Osteoporosis
  • Bone Disease/Arthritis-Rheumatoid Arthritis
  • Chronic Heart Failure (CHF)
  • Diabetes
  • Dyslipidemia
  • End-Stage Renal Disease (ESRD)
  • Hypertension
  • Mental Health Chronic/Disabling Mental Health Conditions
  • Respiratory Disease – Asthma
  • Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD)

2. The IEHP DualChoice Member is prescribed a minimum of five (5) different medications to treat those disease states:

  • ACE-Inhibitors
  • Angiotensin II Receptor Blockers (ARBs)
  • Antidepressants
  • Antihyperlipidemic
  • Antihypertensives
  • Antipsychotics
  • Beta Blockers
  • Bronchodilators
  • Calcium Channel Blockers
  • Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
  • Diuretics
  • Insulins
  • Oral Hypoglycemics
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Tumor Necrosis Factors (TNFs)
  • Inhaled Corticosteroids
  • Calcimimetic
  • Cardiac Glycoside
  • Colony Stimulating Factors
  • Glucagon-Like Peptide-1
  • Glucocorticosteroids
  • Neprilysin Inhibitor
  • NSAIDs
  • Phosphate Binders
  • Vitamin D Analogs

3. Drug costs of $1,233.75 (one-fourth of $4,935) for the previous three months are likely to be incurred.

To learn more about MTM, call IEHP DualChoice (HMO-DSNP) at 1-877-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays.

 

TTY users should call 1-800-718-4347.

 

IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) is dependent on contract renewal.

For answers to frequently asked questions, please download the FAQ document below:

For details, contact the IEHP Pharmaceutical Services Department at (909) 890-2049, Monday-Friday, 8am-5pm.

IEHP DualChoice (HMO-D-SNP) [Medicare-Medicaid Plan] is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.

Information on this page is current as of March 2023.

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