Wednesday, January 20, 2010

HR 3590 and MTM follow-up

Just a little follow-up on my post about the APhA's claim of victory for having MTMs included in HR 3590. With the results of the election to fill the US Senate seat in Massachusetts, the bill may be dead in the water. But I wanted to shed a little more light on what is going on.

A couple days after the post I received an email from an individual at the APhA to discuss exactly what was going on. After a couple days, I was able to have a conversation with this individual at the APhA to discuss some issues.

I guess that my perspective of the inclusion of MTM in the health care bill was a little jaded. My only experience with MTM has been with Medicare Part D, so that is what I thought the health care bill included. You and I both know that the Medicare D carriers are doing very little to allow retail pharmacists to be able to provide this service. As I said in my previous post, two or three cases over three years isn't anything to get excited about.

In my discussion with the individual at the APhA, I learned that the provision for MTMs in the bill was to include all patients. It's not just Medicare D. This is a good thing.

We've all pissed and moaned that we give away our professional knowledge for free. We're the only profession that does so. Well, this is our opportunity to start billing for our professional knowledge. We whine about MAC + 1.75, $4 generics, and free antibiotics. This may be our chance to get the recognition as health care providers (not just pill dispensers) that we deserve.

The corporate owners of pharmacy are only concerned about the P&L, not the professional side of pharmacy. So it's up to us, as individual pharmacists, to step up to the plate if we want this recognition.

With the health care bill in question right now, you need to stay in contact with the movers and shakers in Washington DC. That means calling your Senator, Congressman, and the APhA. If you don't use your voice, you will lose your voice on this and all matters related to pharmacy as it moves forward.

For me personally, I'm planning on heading out to Washington DC in March to meet some of the APhA people and hopefully have some input on matters related to the profession. I've also contacted about fifteen Medicare D plans to enroll myself as an independent provider of MTM services. MTM is a professional service provided by a pharmacist, not the pharmacy. I don't see letting the corporation keep the reimbursement for my professional services. To take things a step further, I've started applying to different medical plans to be included in their networks as an MTM provider. My thinking is this, nobody will pay us for our services if they don't know that we are out here providing them.

Feel free to shoot me an email at if you have any thoughts on this subject.


I.J. said...

Hi Eric,
I am totally with you on this. I too am in the process of setting up my own independent MTM practice and enrolling as an independent MTM service provider so that I can can get reimbursed for my services.

I was surprised that a Google search for "independent MTM pharmacist" listed you as the ONLY pharmacist doing this!!! How sad... MTM is naturally and logically a pharmacist's milieu, certainly not a corporation.

I have been running a niche drug information website for just under a year and now that my site traffic has grown, I plan to begin offering my MTM consulting services to my site visitors. I will complete the APhA MTM certification training program in May at the ASCP Midyear conference. Right now I am still doing my due diligence on software providers to run my practice.

I really think there should be a lot more of us who are doing this so hopefully once the way is paved others will catch on and we can reclaim our profession and truly be recognized as the bona fide healthcare providers we are.

Anonymous said...

What do I need to do to become an independent pharmacist who can provide MTM services on their own? I work for a hospital, but I would like to do this on my own. Please contact me via my website:

Thank you!