Medicare Health Plans

MTM For Medicare Part D

Medicare Advantage and Part D plans have very specialized Medication Therapy Management (MTM) needs.  Since 2010, MTM programs have become more and more regulated.  In 2014 the Comprehensive Medication Review (CMR) was made a STAR measure and in 2015 CMS included the MTM program as a component of the Medicare program audit.  

In sharing our clients’ commitment to quality, CSS provides more than a “check the box” program. Through our proprietary MTMPathTM software platform and a team of experienced management, account support and clinicians, CSS’s standard Part D MTM program ensures regulatory (CMS) compliance, financial ROI and STAR improvement.

  • Comprehensive Medication Reviews (CMRs)
    Increase patient engagement through non-traditional outreach methods to reach your targeted CMR completion rate. Learn more
  • Targeted Medication Reviews (TMRs)
    Take the responsibility off your clinical team by outsourcing this effort to CSS. Learn more

The standard CSS Medicare Part D MTM program focuses on cost, STAR measures, and opioid use.  Thanks to the flexibility of the MTMPath software, our clients can extend their MTM programs to address non-MTM eligible members through add-on programs

  •  STARBoosterLearn more
  • AdherencePath. Learn more
  • High Risk Medication Reduction. Learn More.
  • iDealTherapy
    CSS will help your Plan realize its full savings potential by making recommendations to your members physicians to switch them to lower-cost medication alternatives, eliminate duplicate therapy and minimize non-formulary use. Learn more
  • Opioid Monitoring
    We’ll identify your members most at risk for opioid misuse, abuse and addition. Learn more

These programs can be added to an existing MTM program regardless of whether CSS is your primary MTM vendor or not.

CMR Delivery

Our software has been designed to provide your plan with maximum flexibility in the delivery of CMRs.  Depending on your available clinical resources, you can:

  • Outsource your entire MTM program to CSS
  • Leverage CSS’ clinical team to support your current MTM program
  • License CSS’ web-based MTMPathTM to streamline your operations
  • Let CSS help you build a network of MTM clinicians.

Regardless of your desired level of involvement, we will work with you to develop a successful MTM program to meet your goals.

License Our MTMPathTM Software

CSS’s MTMPathTM platform provides a turn key solution for your Part D MTM program.  MTMPathTM is a cloud solution.  Implementing our cloud solution is a “light” lift for your IT team.  Because all you need is a computer with an internet connection MTMPathTM is very mobil – use the MTMPathTM platform at the office, pharmacy, patient’s home, long term care facility or physicians office and clinic.  MTMPathTM is fully configurable and conforms to your CMS submission. Learn more or request a demo.

Reports

CMS-mandated reports come standard with all of our programs.  Both Beneficiary Level Report (BLR) and Universe Audit File are available through the MTMPathTM Program Dashboard and can be run on demand.  CSS’s standard MTM program also provides a library of administrative, clinical and outcomes reports.  All reports are made available through the Program Dashboard and can be run on demand.  If that’s not enough, CSS will build custom reports to provide the data you need to manage your MTM program.

Data Validation and CMS Audits

All of our clients benefit from CSS’ Data Validation and Audit support services.  We fully support our clients during the validation and audit process, providing policy and procedure documentation and participating in audit calls.