Integrating pharmacists into the patient centered medical home

January 3, 2018

Recently Intermountain Healthcare (IH) reported on effort to integrate pharmacists in their patient centered medical home (PCMH).  IH is an integrated delivery system of 22 hospitals, a medical group with more than 185 ambulatory physician clinics and approximately 1100 primary and secondary care physicians and an affiliated health plan.   Overview Under the auspices of the Collaborative Pharmacist Support Services (CPSS) program, IH embedded clinical pharmacists in primary care medical home practices.  These pharmacists were tasked with multiple patient care responsibilities including the co-management of diabetes (DM) and hypertension (HBP).  These two responsibilities consumed an estimated 50% of the pharmacists’ […]

OIG Green Lights Pharma support of Transitions MTM program

January 2, 2018

Health and Human Service’s Office of Inspector General issued an advisory opinion in December of 2017 indicating that Pharma support of a program to conduct MTM post discharge would not violate anti-kickback rules. The permission was outlined in an advisory opinion by OIG.  An undisclosed drug manufacturer requested that the OIG (the agency responsible for investigating fraud) issue an opinion as to whether their support of an post discharge MTM program violated any anti-kickback laws since the program could lead to pharmacists recommending the drug company’s products. The drug maker, teaming with the American Academy of Managed Care Pharmacists (AMCP), would […]

Is Post Marketing Surveillance an new opportunity for MTM

December 27, 2017

A post marketing requirement (PMR) is a study or clinical trial that a pharmaceutical company is required by statute or regulation to conduct post approval of a drug product. On December 8, 2017 the FDA released it’s annual report summarizing the status of PMR activity from 2010 – 2016 (see table below).     PMR Status Fiscal Year of PMR Establishment 2010 2011 2012 2013 2014 2015 2016 Pending 8 (4%) 16 (6%) 24 (11%) 56 (20%) 114 (39%) 164 (58%) 232 (86%) Ongoing 26 (12%) 49 (19%) 52 (24%) 69 (25%) 80 (27%) 52 (18%) 22 (8%) Submitted 15 […]

CMS Medicare Proposals: Impact on MTM Programs

December 14, 2017

Medicare Proposals On November 28th, the Centers for Medicare and Medicaid Services (CMS) published “Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program” in the Federal Register (the full text of this document can be found at –  This publication proposes revisions to the Medicare Advantage and Prescription Drug Benefit programs.  A number of these revisions are germane to medication therapy management (MTM) and MTM-like activities. Opioid DUR Policy and Overutilization Monitoring System (OMS) The Comprehensive Addiction and Recovery Act […]

The MTM Boat

August 28, 2017

Just Launched! CCD Integration

August 24, 2017

CSS is excited to announce that we have just launched our Continuity of Care Document (CCD) Integration. CCD Integration moves CSS and MTMPathTM significantly along the interoperability path.  With the new CCD Integration functionality, medication and care management clinicians using the MTMPathTM platform can now integrate with any physician and hospital electronic record system to consume CCD documents and effortlessly build a patient profile for medication management review.  CCD integration: Allows for robust therapy gap identification Reduces the administrative burden of data entry and maximizes valuable pharmacist time Allows clinic based pharmacists to significantly scale their medication management efforts over large […]

MTM Pilot Audit Summary of Key Points

June 27, 2017

CSS has put together a list of key points and associated feedback that we gained from: Attending the CMS Spring Conference’s MTM Pilot Audit panel discussion Our direct experience with our first CMS MTM Pilot/Program Audit. 2017 CMS Spring Conference MTM Pilot Audit Panel Discussion FINAL Summary May 2017 We are prepared to work closely with you to support any future MTM audit and hope you find this information useful. If you have any questions pertaining to this summary, please feel free to contact us.

Preparing for Biosimilars

June 26, 2017

Manufacturers of biologic drugs over the past few years have been “pulling out all the stops” to difficult for less expensive biosimilar products to come to market.  Biologic drug manufactures have used tactics like patent infringement suits to delay the availability of biosimilars. Note: Biosimilars are the “generic” equivalent of a biologic drug.  Unlike traditional drugs, biologics are made from living cells and cannot be copied exactly to make generic versions. They are used to treat a range of conditions, including Crohn’s disease, ulcerative colitis, rheumatoid arthritis, plaque psoriasis, breast cancer and diabetes.  The U.S. Supreme Court, in a recent […]

Patient Acceptance of Pharmacist Run Transition of Care Service

June 11, 2017

A recent article in Innovations in Pharmacy ( describes a unique pharmacy based transition of care service.  Kowalski et. al. describe a transitions of care collaboration between Streu’s Pharmacy Bay Natural (an independent community pharmacy in Green Bay, WI) and Bellin Hospital.   Streu’s piloted a transition of care service for the cardiac unit at Bellin. Getting Patients Into Transitions Care Patients in the cardiac unit were eligible for the transition service if they were a Wisconsin resident, had moderate to high risk for readmission and were anticipated to be discharged to their homes (vs. an inpatient rehabilitation or long-term care […]

Drug Related Readmissions

May 17, 2017

A recent study in the March 2017 edition of the Journal of Patient Safety ( highlights the extent to which avoidable medication errors impact early readmissions. In this study, the authors evaluated a  random sample of 534 potentially avoidable 30-day readmissions from 10,275 consecutive discharges.  They found that 70 (13.1%) of readmission were partially or predominantly due to adverse drug events (ADEs) and of these they rated 58 (82.9%) as serious ADEs.  Strikingly, 65 (92.9%) of the ADEs were confirmed to be preventable.  The preventable ADEs were classified as inappropriate prescribing (34 cases, 48.6%), misprescribing (19 cases, 27.1%), underprescribing (8 cases, […]