MTM Documentation Standards & Regulatory Compliance 2

Question 1

Under HIPAA, which of the following constitutes a minimum necessary standard violation in MTM documentation?

Accepted Answer

Sharing a patient's complete medical history with a billing clerk processing an MTM claim

Answer

The minimum necessary standard requires limiting PHI disclosure to only what is needed for a specific purpose; sharing a complete medical history with a billing clerk exceeds that need.

Question 2

Which CMS requirement specifically addresses the timeframe for delivering a written Personal Medication List (PML) to the patient after a CMR?

Accepted Answer

Within 7 calendar days of the encounter

Answer

CMS requires that the PML and written summary be provided to the patient within 14 calendar days of the CMR, but the standard best practice and many plan contracts require delivery within 7 days.

Question 3

A pharmacist conducting an MTM encounter discovers a patient is using a medication not covered by their Part D plan. How should this be documented in the MAP?

Accepted Answer

List it under the patient's complete medication list with notation of payment source

Answer

The Medication Action Plan should reflect all medications the patient uses regardless of coverage status, with notation of cash-pay or other payer source.

Question 4

Which element is REQUIRED in the CMR written summary according to CMS MTM program guidelines?

Accepted Answer

A prioritized list of medication-related action items for the patient

Answer

CMS requires the CMR written summary to include a prioritized list of medication-related action items, along with the PML and follow-up schedule.

Question 5

State pharmacy practice acts that govern MTM documentation most commonly require pharmacists to:

Accepted Answer

Maintain MTM encounter records for a minimum period defined by state law

Answer

Most state practice acts require pharmacists to retain patient care records, including MTM documentation, for a minimum number of years specified by state law.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Documentation Standards & Regulatory Compliance 2