3 ms·

You are asking me to cite things but what are you citing? You are simply saying “that’s not true”. >MTM has nothing to do with insurance. It’s required by la

You are asking me to cite things but what are you citing? You are simply saying “that’s not true”. >MTM has nothing to do with insurance. It’s required by law To be provided by insurers/health plans. If you refuse to talk to pharmacists or doctors about it, fine, you can read the law 42 CFR 423.153. In short insurance companies, must provide MTM services to patient covered in their plans. It is also the single biggest metric in determining an insurers star rating. How could it possibly be unrelated to insurance if insurance companies have to, by law, provide it and it effects their reimbursement/star ratings? >outcomesMTM is not insurance software, it's pharmacy patient management software. That’s funny...the software certainly does manage pharmacists...on behalf of the insurance companies. Right from the outcomes homepage: “Contracted with more than 50 U.S. health plans, OutcomesMTM provides MTM coverage to 5.5 million patients. The company links more than 100,000 local chain, independent and health-system pharmacy providers with contracted plans across the country.” Why does outcomesmtm contract with 50 insurance companies? Why does outcomesMTM “link” pharmacies with contracted plans? “Targeted MTM services are designed to help plan sponsors improve performance for key Star measures, including the triple-weighted adherence measures. Prompted by TIPs in the Connect™ Platform, pharmacists work with patients to impact adherence and optimize medication regimens.” As to generic substitutions...there are laws from state to state that allow pharmacists to do it, UNLESS the doctor says the name brand must be dispensed. I’m afraid that’s common practice, so permission is required. Plus when it comes to Medicare patients a pharmacist isn’t going to just change the RX to generic because they know they: 1 get paid by the insurer through these MTM portals to make the recommendation and 2 get paid again through the portal if/when the doctor agrees to the change.

Wowfunhappy 8y ago
> You are asking me to cite things but what are you citing? GP cannot prove a negative. If this software/system exists, the "burden of proof" is on you.
- will_brown 8y ago
  He said mtm has nothing to do with insurers and ask “where I got my ideas” I said CMS and cited the Law that Medicare insurers have to provide mtm to patients. Then he said outcomesMTM is a pharmacy patient management software having nothing to with insurance, but it’s a software for insurers to pay pharmacies to provide mtm to the insurers patients and I quoted from their website. It’s really above and beyond ridiculous like me saying google is a search engine and someone say no it’s not give me a cite.

Wowfunhappy 8y ago

> You are asking me to cite things but what are you citing? GP cannot prove a negative. If this software/system exists, the "burden of proof" is on you.

will_brown 8y ago
He said mtm has nothing to do with insurers and ask “where I got my ideas” I said CMS and cited the Law that Medicare insurers have to provide mtm to patients. Then he said outcomesMTM is a pharmacy patient management software having nothing to with insurance, but it’s a software for insurers to pay pharmacies to provide mtm to the insurers patients and I quoted from their website. It’s really above and beyond ridiculous like me saying google is a search engine and someone say no it’s not give me a cite.