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Medication therapy management services (MTMS), as outlined in the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA 2003), is likely to have a significant impact on pharmacy practice, Jannet Carmichael, Pharm.D., told attendees at the American College of Clinical Pharmacy annual meeting, held last month in Dallas. She is PBM manager at VISN 21 Health Care Services at the VA Sierra Pacific Network in Reno.