Medication Therapy Management Program (MTMP)

Medication Therapy Management Program

Champion Health Plan has a free voluntary program for members who have multiple medical conditions, take many prescription drugs, have high drug costs, and/or are determined to be at risk for misuse or abuse of an opioid or a frequently abused drug under our Drug Management Program (DMP). Participation is voluntary. You can opt out of the program at any time. The Medication Therapy Management Program is utilized to help members manage medications and make sure our members are receiving medications appropriate for  their medical conditions, identify any possible medication interactions, duplication of therapy, and review drug dosages according to the recommended prescribing standards.

Please note that the Medication Therapy Management Program (MTMP) is not considered a benefit. It is available to you at no cost. You will be automatically enrolled in this program if you meet the criteria of one of the following two groups (1) and/or (2). :

1. Have three or more of the following medical conditions:
   • Alzheimer’s disease
   •  Bone disease-arthritis (including osteoporosis, osteoarthritis, and rheumatoid arthritis)
   •  Chronic congestive heart failure (CHF)
   • Diabetes
   • Dyslipidemia (high cholesterol)
   • End-stage renal disease (ESRD)
   • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
   •  Hypertension (high blood pressure)
   •  Mental health (including depression, schizophrenia, bipolar disorder, and chronic/disabling mental health conditions), and
   • Respiratory disease (including asthma, chronic obstructive pulmonary disease (COPD), and chronic lung disorders).
2. • Take six or more Medicare Part D covered drugs
   • Expect to spend more than a specified amount on covered Medicare Part D prescriptions:
     • $1,276 or more in 2025
3. Are an at-risk beneficiary (ARB) under our Drug Management Program (DMP)

The MTMP offers a comprehensive review of all your medications and discusses with you in person or over the phone on how to better manage your conditions with drug therapy. If you are eligible for this program, you will be notified by mail. We will then contact you by telephone to perform this service. Each session takes about 20-30 minutes. After the review session, we will send you a Personal Medication List (PML) and Medication Action Plan (MAP) which are summaries of what we’ve talked about. We will also perform Targeted Medication Review quarterly and may contact you or your doctor directly if there are questions about your medications. In addition, you will receive information on the safe disposal of prescription medications that are controlled substances.

*A sample of the Personal Medication List is available for viewing in the link below.

If you would like additional information about the program, please call our Member Services Department at 1-800-885-8000 | TTY 711, 8:00 a.m. to 8:00 p.m., 7 days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30. Calls to this number are free. Member Services also has free language interpreter services available for non-English speakers. TTY requires special telephone equipment and is only for people who have difficulties with hearing or speaking.