ALLcrimesfood&drugstaxestelecomcommercehealthconservationtransportationagricultureveteransbrowse all titles »
0

42 U.S.C. § 299b–35Grants or contracts to implement medication management services in treatment of chronic diseases

submitted 82 years ago by Pub. L. 111-148 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 952 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Secretary must fund pharmacists to provide medication management services for chronic disease patients. Eligible entities need a suitable setting, and services must include medication reviews and patient education. The Secretary must report to Congress on how well the program works.

(a) In general. The Secretary, acting through the Patient Safety Research Center (the "Center"), must set up a program of grants or contracts so eligible entities can offer medication therapy management (MTM) services from licensed pharmacists — a team-based approach to treating chronic diseases for targeted patients — to improve care quality and cut overall treatment cost. The program must start by May 1, 2010. (b) Eligible entities. To get a grant or contract, an entity must: (1) Have a setting suitable for MTM services, as recommended by the experts in (e). (2) Submit a plan for long-term financial sustainability. (3) Where relevant, submit a plan to coordinate MTM services through local community health teams or primary care extension programs. (4) Submit a plan for meeting the requirements in (c). (5) Submit any other information the Secretary requires. (c) MTM services to targeted individuals. As allowed by state law (including pharmacy practice agreements), MTM services funded under this section must include: (1) Assessing each patient's health and functional status. (2) Creating a medication treatment plan agreed on by the prescriber and the patient (or caregiver/representative). (3) Selecting, starting, changing, recommending changes to, or giving medication therapy. (4) Monitoring — which may include ordering or doing lab tests — and evaluating how the patient responds, including safety and effectiveness. (5) Doing an initial full medication review to catch, fix, and prevent medication problems (including bad drug reactions), plus quarterly targeted reviews and follow-up as needed with the prescriber. (6) Documenting care given and sharing key information — including a review summary and the pharmacist's recommendations — with the patient's other providers promptly. (7) Educating and training the patient, caregiver, or representative to understand and properly use medications. (8) Giving information, support, and strategies to help patients stick with their treatment plans. (9) Coordinating MTM services with the patient's broader health care. (10) Other patient care services allowed under pharmacist practice rules used in other federal MTM programs. (d) Targeted individuals. MTM services must be offered to patients who: (1) Take 4 or more prescribed medications (including over-the-counter drugs and supplements); (2) Take any "high risk" medications; (3) Have 2 or more chronic diseases, as the Secretary identifies; or (4) Have gone through a care transition or other factor the Secretary decides creates a high risk of medication problems. (e) Consultation with experts. In designing and running MTM services, the Secretary must consult federal, state, private, public-private, and academic groups, pharmacy organizations, health care organizations, consumer advocates, chronic disease groups, and other relevant stakeholders — and, with them, decide whether to use rapid-cycle process improvement methods already used in other federal MTM programs. (f) Reporting to the Secretary. A grant or contract recipient must report to the Secretary, describing and evaluating the (c) activities as requested, including quality measures endorsed by the entity with the section 1395aaa contract, as the Secretary determines. (g) Evaluation and report. The Secretary must report to the relevant congressional committees, assessing: (1) How clinically effective pharmacist-provided MTM services are compared to usual care, including whether enrollees had better health with fewer hospital and ER visits than similar unenrolled patients. (2) Changes in overall health care resource use by targeted patients. (3) Patient and prescriber satisfaction with MTM services. (4) The effect of patient cost-sharing on medication adherence, and recommended changes. (5) Other factors affecting clinical and economic outcomes — like demographics, clinical traits, health service use, the medication regimen, the pharmacy benefit, and the MTM services given. (6) Whether pharmacists who also dispense medications face a conflict of interest providing MTM services, and if so, recommendations to address it. (h) Grants or contracts to fund development of performance measures. Through the quality measure development program in section 299b–31, the Secretary may award grants or contracts to develop performance measures that assess how well medication therapy management services work.
the actual law source: uscode.house.gov ↗public domain
(a) In general

The Secretary, acting through the Patient Safety Research Center established in section 299b–33 of this title (referred to in this section as the “Center”), shall establish a program to provide grants or contracts to eligible entities to implement medication management (referred to in this section as “MTM”) services provided by licensed pharmacists, as a collaborative, multidisciplinary, inter-professional approach to the treatment of chronic diseases for targeted individuals, to improve the quality of care and reduce overall cost in the treatment of such diseases. The Secretary shall commence the program under this section not later than May 1, 2010.

(b) Eligible entities

To be eligible to receive a grant or contract under subsection (a), an entity shall—

(1)

provide a setting appropriate for MTM services, as recommended by the experts described in subsection (e);

(2)

submit to the Secretary a plan for achieving long-term financial sustainability;

(3)

where applicable, submit a plan for coordinating MTM services through local community health teams established in section 256a–1 of this title or in collaboration with primary care extension programs established in section 280g–12 of this title;

(4)

submit a plan for meeting the requirements under subsection (c); and

(5)

submit to the Secretary such other information as the Secretary may require.

(c) MTM services to targeted individuals

The MTM services provided with the assistance of a grant or contract awarded under subsection (a) shall, as allowed by State law including applicable collaborative pharmacy practice agreements, include—

(1)

performing or obtaining necessary assessments of the health and functional status of each patient receiving such MTM services;

(2)

formulating a medication treatment plan according to therapeutic goals agreed upon by the prescriber and the patient or caregiver or authorized representative of the patient;

(3)

selecting, initiating, modifying, recommending changes to, or administering medication therapy;

(4)

monitoring, which may include access to, ordering, or performing laboratory assessments, and evaluating the response of the patient to therapy, including safety and effectiveness;

(5)

performing an initial comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events, quarterly targeted medication reviews for ongoing monitoring, and additional followup interventions on a schedule developed collaboratively with the prescriber;

(6)

documenting the care delivered and communicating essential information about such care, including a summary of the medication review, and the recommendations of the pharmacist to other appropriate health care providers of the patient in a timely fashion;

(7)

providing education and training designed to enhance the understanding and appropriate use of the medications by the patient, caregiver, and other authorized representative;

(8)

providing information, support services, and resources and strategies designed to enhance patient adherence with therapeutic regimens;

(9)

coordinating and integrating MTM services within the broader health care management services provided to the patient; and

(10)

such other patient care services allowed under pharmacist scopes of practice in use in other Federal programs that have implemented MTM services.

(d) Targeted individuals

MTM services provided by licensed pharmacists under a grant or contract awarded under subsection (a) shall be offered to targeted individuals who—

(1)

take 4 or more prescribed medications (including over-the-counter medications and dietary supplements);

(2)

take any “high risk” medications;

(3)

have 2 or more chronic diseases, as identified by the Secretary; or

(4)

have undergone a transition of care, or other factors, as determined by the Secretary, that are likely to create a high risk of medication-related problems.

(e) Consultation with experts

In designing and implementing MTM services provided under grants or contracts awarded under subsection (a), the Secretary shall consult with Federal, State, private, public-private, and academic entities, pharmacy and pharmacist organizations, health care organizations, consumer advocates, chronic disease groups, and other stakeholders involved with the research, dissemination, and implementation of pharmacist-delivered MTM services, as the Secretary determines appropriate. The Secretary, in collaboration with this group, shall determine whether it is possible to incorporate rapid cycle process improvement concepts in use in other Federal programs that have implemented MTM services.

(f) Reporting to the Secretary

An entity that receives a grant or contract under subsection (a) shall submit to the Secretary a report that describes and evaluates, as requested by the Secretary, the activities carried out under subsection (c), including quality measures endorsed by the entity with a contract under section 1395aaa of this title, as determined by the Secretary.

(g) Evaluation and report

The Secretary shall submit to the relevant committees of Congress a report which shall—

(1)

assess the clinical effectiveness of pharmacist-provided services under the MTM services program, as compared to usual care, including an evaluation of whether enrollees maintained better health with fewer hospitalizations and emergency room visits than similar patients not enrolled in the program;

(2)

assess changes in overall health care resource use by targeted individuals;

(3)

assess patient and prescriber satisfaction with MTM services;

(4)

assess the impact of patient-cost sharing requirements on medication adherence and recommendations for modifications;

(5)

identify and evaluate other factors that may impact clinical and economic outcomes, including demographic characteristics, clinical characteristics, and health services use of the patient, as well as characteristics of the regimen, pharmacy benefit, and MTM services provided; and

(6)

evaluate the extent to which participating pharmacists who maintain a dispensing role have a conflict of interest in the provision of MTM services, and if such conflict is found, provide recommendations on how such a conflict might be appropriately addressed.

(h) Grants or contracts to fund development of performance measures

The Secretary may, through the quality measure development program under section 299b–31 of this title, award grants or contracts to eligible entities for the purpose of funding the development of performance measures that assess the use and effectiveness of medication therapy management services.

Source credit: (July 1, 1944, ch. 373, title IX, § 935, as added and amended Pub. L. 111–148, title III, § 3503, title X, § 10501(f)(4), Mar. 23, 2010, 124 Stat. 516, 996.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 111-148 · 124 Stat. 516, 996

A history note hasn’t been published yet. The record shows enactment by Pub. L. 111-148 on 1944-07-01.

all 0 arguments · sorted by: best

0/280

no arguments yet — make the first case