Does the plan utilize and/or encourage mail order (prescriptions and HME, including diabetes supplies)?
Mail order programs are a part of many MA plans. As part of the “level playing field” provision of Part D, plans cannot mandate mail order but they can provide incentives for beneficiaries to use mail order rather than going to their local pharmacy for prescription drug benefits and HME supplies such as diabetes supplies. • Does the MAPD plan offer pharmacy-delivered MTM services or other pharmacy-based clinical interventions for its patients? As part of the Medicare Modernization Act, all Part D and MAPD plans are required to have an MTM program for targeted high-risk beneficiaries. These plans are given flexibility to establish parameters for targeting these beneficiaries and how they administer the program. MAPDs are more likely than PDPs to have strong MTM and clinical programs because, while the MTM program may increase an MAPD plan’s prescription drug spending, the benefits on decreased hospitalizations and physician visits make up for this risk. • Does the MAPD plan offer adequa
