The NYS Medicaid Medication Therapy Management Pilot Program
On January 6, 2010, the Medicaid Program implemented a pilot Medication Therapy Management (MTM) Program to improve therapeutic outcomes by optimizing responses to medication, managing treatment-related interactions or complications, and improving adherence to drug therapy.
The Medicaid MTM pilot program was offered to Medicaid beneficiaries residing in the Bronx who were identified as eligible to receive program services through a review of their medication and facility (emergency department and in-patient) Medicaid claims. Patient enrollment was voluntary.
All MTM services were provided at designated pharmacies located in the Bronx by qualified Medicaid MTM pharmacists who possessed a New York State license to practice pharmacy and were enrolled as NYS Medicaid providers with the MTM pharmacist category of service. Claims for MTM services were billed by and paid to pharmacies who employed a qualified Medicaid MTM pharmacist.
The pilot was discontinued on April 2, 2012 as it was unable to obtain meaningful patient enrollment. While many viable options to expand enrollment were considered the State's overall strategy to move fee-for-service Medicaid beneficiaries into managed care ran counter to any additional fee-for-service MTM program development and/or expansion.
Questions regarding this program can be emailed to the Medicaid Pharmacy Program at PPNO@health.state.ny.us.