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Get the free MTM Program PML Member Form - PacificSource Medicare

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PERSONAL MEDICATION LIST FOR: DOB: This medication list may help you keep track of your medications and how to use them the right way. Keep this list up-to-date with: ? Use blank rows to add new medications.
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MTM Program PML Member stands for Medication Therapy Management Program Part D Plan Member.
Medicare Part D plan sponsors are required to file MTM Program PML Member data.
MTM Program PML Member data can be filled out through the appropriate CMS form or electronic submission.
The purpose of MTM Program PML Member is to improve medication use and outcomes for Medicare beneficiaries.
Information such as medication therapy interventions, adherence rates, and outcomes must be reported on MTM Program PML Member.
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