The Medication Therapy Management (MTM) Program supports VIVA MEDICARE members with complex, long-term health problems by helping them take their prescription drugs in a safe and structured manner.
Select at-risk members are automatically enrolled in the MTM Program. There is no cost to the member. To be selected for the MTM Program, members must meet VIVA MEDICARE's Drug Management Program guidelines and/or ALL of the following three (3) standards:
2024 MTM Program Criteria
1. Take eight (8) or more drugs from the following specific Part D drug classes:
- Alpha Blockers,
- angiotensin-converting enzyme (ACE) inhibitors,
- angiotensin II receptor blockers (ARBs),
- antihyperlipidemics,
- antihypertensives,
- beta blockers,
- calcium channel blockers,
- diuretics,
- insulins,
- oral hypoglycemics,
- bisphosphonates,
- digoxin,
- hydralazine,
- nitrates,
- vasodilators,
- abaloparatide,
- calcitonin salmon nasal,
- denosumab,
- romosozumab,
- teriparatide
AND
2. Have three (3) or more of the following long-term health conditions:
- Osteoporosis
- Chronic Heart Failure (CHF)
- Diabetes
- Dyslipidemia
- Hypertension
AND
3. Expect to spend at least $4,935 for calendar year 2023 or $5,330 for calendar year 2024 on prescription drugs.
Members selected for the MTM Program are sent a letter welcoming them and letting them know they have been enrolled. They will get a call from either a partnering local pharmacy, an MTM call center, a VIVA MEDICARE pharmacist, or a qualified provider to go over the prescriptions and/or over-the-counter drugs the member is taking. This is called a Comprehensive Medication Review (CMR) and takes about 30 minutes. It is usually offered once each year.
A specially trained pharmacist or other qualified provider will review the member's drug list to see if there are any problems with certain drugs being taken together. If problems are found, we will work with the member and prescriber to see what drugs, if any, should be changed.
After the CMR, members will be mailed a Medication Action Plan that outlines steps the member should take to get the best results from the prescriptions and/or over-the-counter drugs the member is taking. Members will get a Personal Medication List that helps keep track of each drug and when/how it should be taken. This keeps members safe and ensures the drugs are as effective as possible.
In addition to the CMR, members may get a Targeted Medication Review (TMR). During a TMR, pharmacy claims are reviewed every three months to make sure there are not any new or ongoing drug therapy problems, like a potential safety problem and/or a gap in getting prescriptions filled. If any issues are found, members will be contacted by VIVA MEDICARE or the prescriber.
All members enrolled in VIVA MEDICARE's MTM Program will be taught how to safely dispose of (throw away) any prescription drugs that are controlled substances. A controlled substance is a prescription drug that can cause physical and mental dependence. These drugs need to be disposed of more carefully through local take-back programs and proper in-home disposal.
Enrolled members can disenroll from the MTM Program any time during the year or stay enrolled but decline some services.
For more information on VIVA MEDICARE's Medication Therapy Management Program, please call our member services department at 1-800-633-1542 or 205-918-2067. TTY users, call 711. They can take your call Monday-Friday, 8 am - 8 pm. From October 1 to March 31, they are open seven days a week, 8 am - 8 pm.