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

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 MedWiseRx (formerly SinofiaRx) 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 thesemedications are working.
  • The participant is informed of any potential side effects and how to better managethese 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?

We will determine if a participant is eligible for the MTMP using pharmacy claims data. Eligible Participants will receive an informational packet by mail. The requirements for eligibility in the MTMP are that a participant must:

  • Have at least 3 of the following specific chronic diseases:
    • Alzheimer's Disease
    • Chronic Heart Failure (CHF)
    • DiabetesoDyslipidemia
    • Hypertension
    • Mental Health – Bipolar Disorder
    • Mental Health – Depression
    • Mental Health – Schizophrenia
    • Respiratory Disease – Asthma
    • Respiratory Disease – Chronic Obstructive Pulmonary Disease(COPD)

AND

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

AND

  • Incurred one-fourth of specified annual cost threshold ($5,330) 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 6.6.23