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PHP Care Complete FIDA-IDD Plan (Medicare – Medicaid Plan)

2025 Medication Therapy Management Program (MTMP)

PHP Care Complete FIDA-IDD Plan (Medicare – Medicaid Plan) wants to make sure our Participants are getting the most out of the prescription drugs they use. The Medication Therapy Management Program (MTMP) is administered through Aspen RxHealth and MedImpact who work with PHP Care Complete FIDA-IDD Plan to improve the way prescription drugs are used by their participants. The MTMP is available to eligible participants at no cost. The MTMP is not considered a benefit.

What is the Medication Therapy Management Program (MTMP)?

The Medication Therapy Management Program (MTMP) is an in-depth one-on-one review of all of a participant’s medications (prescriptions, supplements and over-the-counter drugs). The goal is to help the participant get the most from all of their medications.

What does the MTMP Pharmacist do?

The MTMP Pharmacist will review the eligible participant’s health status and treatment plan. This is done so that the pharmacist can help make sure that:

  • The participant is taking only the medication that is needed and that these medications are working.
  • The participant is informed of any potential side effects and how to better manage these side effects.
  • The participant is taking the correct amount of medicine at the right time.
  • The medications are not interacting with each other.
  • The prescriptions, over-the counter drugs and other medications are safe andeffective.

What determines if a participant is eligible and what are the eligibility requirements?

The MTMP is only offered to enrollees who meet speficied targeting criteria per CMS requirements. We will determine if a participant is eligible for the MTMP using pharmacy claims data. Eligible Participants will receive an informational packet by mail regarding enrollment into the MTMP.

We will target individuals who are considered at-risk beneficiaries (ARBs), as defined at 42 CFR § 423.100. ARBs are individuals with an active coverage limitation under a drug management program(DMP).

We also enroll other individuals into the MTMP who meet the following criteria:

  • Have at least 3 of the following specific chronic diseases:
    • Alzheimer's Disease
    • Chronic Heart Failure (CHF)
    • Diabetes
    • Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
    • Dyslipidemia
    • Hypertension
    • End-Stage Renal Disease (ERSD)
    • Human immunodeficiency virus/acquired immunodeficiency (HIV/AIDS)
    • Mental health (including depression, schizophrenia, bipolar disorder, and other chronic/disabling mental health conditions)
    • Respiratory Disease (including asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung disorders)

AND

  • Be on at least 8 covered Part D drugs (Chronic/Maintenance Drugsapply)

AND

  • Incurred one-fourth of specified annual cost threshold ($1,623) in previous three months

If you have questions, please call PHP Care Complete FIDA-IDD Plan at 1-855-747-5483, and 711 for TTY users, 8AM to 8PM, seven days a week.
You can also call MedImpact at 1-888-648-6759. The call is free. For more information, visit www.phpcares.org

Revised 4.23.25

Medication Therapy Management Program - Medication List