Bill authorizing Medi-Cal payments for MTM introduced

April 6, 2016

A bill that would authorize California’s Medi-Cal program to reimburse pharmacists for medication therapy management has been introduced in the State Legislature.

A bill that would authorize the state’s Medi-Cal program to reimburse pharmacists for medication therapy management (MTM) has been introduced in the California State Legislature.

Jim Wood (D-Healdsburg)Assemblymen Jim Wood (D-Healdsburg) authored the bill. It was sponsored by the California Pharmacists Association (CPhA), and is scheduled to be considered by the legislature’s Appropriations Committee later this month.

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If approved, the bill would ensure reimbursement to pharmacists providing MTM services to Medi-Cal beneficiaries. It also seeks to facilitate clinical interaction between patients, pharmacists, and primary care providers.

“Many patients, especially those with chronic diseases, see multiple doctors and take many different medications, it can be overwhelming,” Wood said.

“By simply having a pharmacy professional go over the prescriptions and coach patients through the process we will have a healthier California,” Wood said.

According to the California Department of Public Health, healthcare costs directly related to arthritis, asthma, cardiovascular disease, diabetes, cancer, and depression cost California taxpayers more than $98 billion annually.

 

“As the state looks to manage the cost, quality of care, and access challenges posed by the 12 million Californians enrolled in the Medi-Cal program, we need to concentrate efforts on high-risk patients with chronic disease,” said Jon Roth, CPhA’s CEO.

“Managing treatment through [MTM] presents a major opportunity to improve care for patients and reduce costs to the State of California,” Roth said.

“By aligning the Medi-Cal payment system with the most pressing and expensive healthcare conditions and the pharmacist’s unique position to manage this chronic care, we can improve the health of Californians in a fiscally cost-effective manner,” Roth said.