IEHP offers Medication Therapy Management (MTM) to qualified members. MTM is a term used to describe a broad range of services offered by pharmacists on our health care team.
The IEHP Clinical Pharmacy team reviews your medicines, making sure you’re taking the right ones for your health conditions. If you are a member who qualifies for the MTM Program, you will receive a letter from us. You will be enrolled - unless you opt-out. The program costs $0 for those who qualify.
Who might be eligible?
Members will be enrolled in IEHP’s DualChoice (HMO D-SNP) MTM program if they meet one of the following:
1. Meet specific eligibility criteria (must meet each criterion):
- The member has a minimum of three (3) disease states:
- Alzheimer’s disease
- Bone disease/arthritis/osteoporosis
- Chronic heart failure (CHF)
- Diabetes
- Dyslipidemia
- End-stage renal disease (ESRD)
- HIV/AIDS
- Hypertension
- Chronic/disabling mental health conditions
- Respiratory disease – asthma, chronic obstructive pulmonary disease (COPD), and chronic lung disorders
- The member is prescribed a minimum of eight (8) different Part D maintenance medications.
- Drug costs of $405.75 (one-fourth of $1,623) for the previous three months are likely to be incurred.
2. Are determined to be an at-risk beneficiary (ARB) due to opioid use and are part of our Drug Management Program (DMP).
Enrolled members are eligible to receive the following services:
- Annual comprehensive medication review (CMR)
- Quarterly targeted medication review (TMR)
Our IEHP Clinical Pharmacy Team will review your medicines, family history, disease states and goals for medicine therapy. Based on a full review, this team then offers recommendations to you and your providers.
A team of registered pharmacists and technicians work with your doctor (or other provider), pharmacies, and our Care Management teams to offer a “whole health” care approach to you.
Medicare MTM Program
The MTM program is not considered a benefit. Program services are offered at no extra cost for eligible IEHP DualChoice members.
Once enrolled in this voluntary program, you will get a welcome packet by mail with details on next steps, including how to receive this service with an MTM provider. You’ll also get information on how to disenroll, should you choose not to be in the program. If you decide not to take part in the program, your enrollment and eligibility with IEHP DualChoice will not change. We hope that if you qualify that you will take part in this program that is offered free of charge—to help you better manage your medicines.
The MTM program includes a yearly comprehensive medication review (CMR), a quarterly targeted medication review (TMR), and annual safe disposal information. Here are some details on MTM services:
| Comprehensive Medication Review (CMR) | Every year you qualify, an IEHP Clinical Pharmacist will call you to complete your annual comprehensive medication review (CMR). The pharmacist will go over all your medicines (prescription, over the counter, and supplements) to make sure you have the right ones for your conditions and that you avoid drug interactions. The CMR may take about 30 minutes for the pharmacist to review all this information with you.
Once your CMR is done, you will get your Medication Action Plan (MAP) and Personal Medication List (PML) by mail within 14 days. These documents can be accessed by calling IEHP Member Services and asking to speak to the clinical pharmacy team. |
|---|---|
| Targeted Medication Review (TMR) | The clinical pharmacy team will also complete a targeted medication review (TMR) at least quarterly throughout the year by reviewing for potential issues with your medicines. You may get TMR recommendations by mail and your primary care provider may receive recommendations by fax—if the clinical pharmacy team deems it necessary. |
| SAFE DISPOSAL INFORMATION | Annually, you will also receive information on the safe disposal of prescription medications that are controlled substances. |
For more information, IEHP DualChoice Members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8 a.m.-8 p.m. (PST), seven days a week, including holidays. TTY users should call 1-800-718-IEHP (4347). MTM documents, including a blank medication list, can be made available upon request.
IEHP DualChoice (HMO D-SNP) is an HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) is dependent on contract renewal.
Information on this page is current as of April 11, 2025.
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