THIS IS BIG!
House Bill 628 and Senate Bill 398 – Pharmacist-Provided Medication Therapy Management (MTM) for TennCare Patients – was funded by the legislature and PASSED by the Tennessee House and Senate unopposed! It now moves on to Governor Bill Haslam to be signed into law!
As one of TPA’s top legislative priorities for 2017, TPA is proud to have worked with lawmakers, TennCare, and pharmacy advocacy groups to pass this important legislation on behalf of our members, the pharmacy profession, and most importantly, our patients. TPA greatly appreciates the support of Senator Ferrell Haile and Representative Sabi ‘Doc’ Kumar, who introduced the legislation, as well as legislation co-sponsors, Senator Doug Overbey and Representatives Bryan Terry, John Ragan, Kevin Brooks, and John Holsclaw. TPA also appreciates the unanimous support of the Tennessee General Assembly, including pharmacy advocates Lieutenant Governor Randy McNally, House Health Chairman Cameron Sexton, and Senate Health Chairman Rusty Crowe.
TPA is especially grateful to every one of our valuable members who actively contributed to the passage of this important legislation by contacting legislators and advocating in support of this patient-focused legislation! Without your engagement, this legislative victory would not have happened!
- Legislation: HB 0628 / SB 0398
- House Sponsor(s): Kumar, Terry, Ragan, Brooks K, Holsclaw
- Senate Sponsor(s): Haile, Overbey
- Description of Legislation:
- Statutory Requirement: Requires TennCare to develop and implement an MTM pilot program that seeks to provide high quality, cost-effective services in support of initiatives administered by the Bureau to ensure optimal health outcomes for TennCare beneficiaries.
- Patient Eligibility for Pharmacist-Provided MTM in Medicaid Pilot Program: Requires TennCare to establish patient eligibility based on use of specific medications, use of classes of medications, disease states, health conditions, mental health conditions, complex medical and drug-related needs, and other clinical factors.
- Qualifications for Pharmacist Participation in MTM in Medicaid Pilot Program: Authorizes qualified Tennessee-licensed pharmacists to provide MTM services to eligible TennCare patients in collaboration with prescribers, patients, caregivers, and other healthcare providers, as appropriate.
- Role of Pharmacy Technicians in MTM in Medicaid Pilot Program: Authorizes pharmacists to delegate technical responsibilities related to MTM services to pharmacy technicians, including obtaining accurate medication histories and records, scheduling visits, documentation, and billing for services.
- Reimbursement for Pharmacist-Provided MTM Services: Requires TennCare to establish reimbursement rates for medication therapy management services provided by pharmacists within the MTM in Medicaid pilot program.
- Pharmacist Enrollment as Providers: Authorizes TennCare, or its managed care organizations, to enroll individual pharmacists as providers under their Medicaid provider program for the purposes of reimbursement for the MTM in Medicaid pilot program.
- Outcomes and Savings Measured: Requires that any cost savings realized by TennCare through this MTM in Medicaid pilot program be prioritized for use in expanding the administration of the MTM in Medicaid pilot program according to overall impact on cost-effectiveness and medical outcomes.