CCP Medication Therapy Management 2 — Questions and Answers
Question 1: Under CMS guidelines, which Medicare beneficiaries are REQUIRED to be targeted for MTM program enrollment?
- Patients with 2+ chronic conditions, 2+ medications, and likely to incur $4,000+ annual drug costs
- All Medicare Part D enrollees regardless of condition burden
- Patients with 3+ chronic conditions, 8+ medications, and likely to incur $5,503+ annual drug costs (Correct answer)
- Any patient receiving a high-risk medication per Beers Criteria
Correct answer: Patients with 3+ chronic conditions, 8+ medications, and likely to incur $5,503+ annual drug costs
CMS requires MTM programs to target beneficiaries with 3+ chronic conditions, 8+ Part D drugs, and an annual drug cost threshold of at least $5,503.
Question 2: A pharmacist conducting a Comprehensive Medication Review (CMR) identifies a drug therapy problem where a patient is taking an NSAID chronically without a gastroprotective agent despite a history of peptic ulcer disease. This is best classified as:
- Unnecessary drug therapy
- Needs additional drug therapy (Correct answer)
- Dosage too low
- Adverse drug reaction
Correct answer: Needs additional drug therapy
The absence of a required gastroprotective agent in a high-risk NSAID user represents a need for additional drug therapy to prevent a known complication.
Question 3: When documenting a CMR using the SOAP note format, the medication action plan (MAP) is best incorporated into which section?
- Subjective
- Objective
- Assessment
- Plan (Correct answer)
Correct answer: Plan
The MAP, which outlines recommended patient actions, is a patient-friendly document that corresponds to the Plan section of the SOAP note.
Question 4: A 78-year-old patient on warfarin reports adding cranberry juice to his daily routine. Which monitoring parameter should the pharmacist prioritize reassessing most urgently?
- Serum creatinine
- INR (Correct answer)
- Complete blood count
- Serum potassium
Correct answer: INR
Cranberry juice inhibits CYP2C9, increasing warfarin exposure and elevating bleeding risk, making INR the most urgent parameter to reassess.
Question 5: During a Targeted Medication Review (TMR), a pharmacist identifies that a patient's beta-blocker dose was reduced by the PCP but the pharmacy refill record shows the patient is still dispensing the old higher dose. The most appropriate initial action is:
- Dispense the higher dose until the next CMR
- Contact the prescriber to clarify the intended dose (Correct answer)
- Counsel the patient to split the existing tablets
- Document the discrepancy and monitor at the next visit
Correct answer: Contact the prescriber to clarify the intended dose
A discrepancy between the prescriber's intended dose and actual dispensing requires immediate prescriber clarification to prevent overmedication.
Question 6: Which of the following best describes the primary distinction between a CMR and a TMR in an MTM program?
- CMR is face-to-face only; TMR may be telephonic
- CMR is a comprehensive annual review; TMR is an ongoing, targeted assessment between CMRs (Correct answer)
- CMR requires physician co-signature; TMR does not
- CMR covers only prescription drugs; TMR includes OTCs and supplements
Correct answer: CMR is a comprehensive annual review; TMR is an ongoing, targeted assessment between CMRs
A CMR is a comprehensive once-yearly review of all medications, while a TMR is an ongoing, problem-focused assessment conducted between CMRs.
Question 7: A pharmacist is reconciling medications for a newly admitted long-term care resident and discovers the patient has been taking two different brand/generic versions of the same antihypertensive prescribed by two separate physicians. This best represents which type of drug therapy problem?
- Adverse drug reaction
- Unnecessary drug therapy due to therapeutic duplication (Correct answer)
- Dosage too high
- Non-adherence
Correct answer: Unnecessary drug therapy due to therapeutic duplication
Receiving the same drug from two prescribers under different names constitutes therapeutic duplication, classified as unnecessary drug therapy.
CCP Medication Therapy Management 2
Under CMS guidelines, which Medicare beneficiaries are REQUIRED to be targeted for MTM program enrollment?