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Medication Therapy Management Pilot Program

  • Medication Therapy Management (MTM) 
    • Medication therapy management (MTM) program is defined as distinct service or group of services which optimizes therapeutic outcomes for individual TennCare members.  MTM services include medication reviews, pharmacotherapy consult, anticoagulation management, immunizations, health and wellness programs and many other clinical services. 
    • Pharmacists provide MTM services to help TennCare members get the best benefits from their medications by managing drug therapy and by identifying, preventing, and resolving medication-related problems.  
  • Pharmacist Participation in MTM in Medicaid Pilot Program
    • The pilot authorizes qualified Tennessee-licensed pharmacists to provide MTM services to eligible TennCare members under a collaborative practice agreement (CPA) with TennCare Patient Centered Medical Homes (PCMH) and Health Link (THL) organizations. 
  • Minimum Requirements:
    • Pharmacist must have a valid Tennessee License
    • Pharmacist must apply to and obtain a Tennessee Medicaid ID
    • A written collaborative practice agreement (CPA) is required between the PCMH/THL and pharmacist.
    • Must have a Managed Care Organizations (MCO) Network and Credentialing agreement 
    • Care Coordination Tool (CCT) Training 
    • Insurance Requirements
      • Pharmacist should contact their malpractice Insurance to see if they have appropriate coverage.
      • Professional Liability
        • At all times during the term of this Agreement, Pharmacist shall maintain professional liability insurance as is necessary to adequately protect TennCare Members and TennCare under this Agreement, including maintaining such tail or prior acts coverage necessary to avoid any gap in coverage for claims arising from incidents occurring during the term of this Agreement. Such insurance shall
        • (i) be obtained from a carrier authorized to conduct business in the jurisdiction in which Pharmacist operates,
        • (ii) maintain minimum policy limits of at least $1,000,000.00 per occurrence and $3,000,000.00 in the aggregate; and
        • (iii) include coverage for the professional acts and omissions of Pharmacist and any employee, agent or other person for whose acts or omissions Pharmacist is responsible.
  • Tennessee has developed a shared Care Coordination Tool that will allow providers participating in the Patient Centered Medical Home (PCMH) and Tennessee Health Link (THL) programs to be more successful in the state’s new payment models.  The tool will identify and track the closure of gaps in care linked to quality measures.
  • Complete the TennCare Acceptable Use Policy and Registered Authorization Requests for your CCT administrator.
    • Automated CCT Registration will begin November 10th. Once pharmacist has a collaborative practice agreement (CPA) with an approved PCMH or THL, please email the TennCare MTM Pilot Network Team (TennCare.Pharmacy.AdobeSign@tn.gov) to initiate the user agreement (security) process.
    • Altruista (CCT) Support HelpDesk Contact
      • support@altruistahealth.com
      • Please note, the Altruista HelpDesk email address has been set up with specific parameters to only process emails from approved email address domains. Each organization’s business-specific email domains have already been included in these parameters. However, emails sent from non-specific domains such as Gmail, Yahoo, AOL or Hotmail are not able to be processed by the HelpDesk.
      • For those without a business-specific email domain, the Altruista HelpDesk will continue to be available via phone at 855-596-2491. For questions regarding whether your business-specific email domain is an approved email domain, please call the Altruista HelpDesk.
  • PCMH/THL Intro to Training
  • CCT Training Materials
  • Email any questions direct to the TennCare MTM Pilot Network team: TennCare.MTMpilot@tn.gov
  • MTM Pharmacists can arrange a demonstration or schedule online training with a CCT team member: TennCare.MTMpilot@tn.gov

** Check back frequently for updates. **

Questions? Email us and we can help you sign up. TennCare.MTMpilot@tn.gov