"SEC. 935. GRANTS TO IMPLEMENT MEDICATION MANAGEMENT SERVICES IN TREATMENT OF CHRONIC DISEASES.

(a) IN GENERAL.-The Secretary, acting through the Patient Safety Research Center established in section 933 (referred to in this section as the Center) shall estab-lish a program to provide grants to eligible entities to im-plement medication management (referred to in this sec-tion as MTM) services provided by licensed pharmacists, as a collaborative, multidisciplinary, inter-professional ap-proach to the treatment of chronic diseases for targeted individuals, to improve the quality of care and reduce over-all cost in the treatment of such diseases. The Secretary shall commence the grant program not later than May 1, 2010.

(b) ELIGIBLE ENTITIES.-To be eligible to receive a grant 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 coordi-nating MTM services through local community health teams established in section 212 of the Af-fordable Health Choices Act or in collaboration with primary care extension programs established in sec-tion 399T;

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

(5) submit to the Secretary such other infor-mation as the Secretary may require. (c) MTM SERVICES TO TARGETED INDIVIDUALS.-

The MTM services provided with the assistance of a grant 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 an MTM 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 MTM services;

(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 medi-cation review to identify, resolve, and prevent medi-cation-related problems, including adverse drug events, quarterly targeted medication reviews for on-going monitoring, and additional followup interven-tions 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 in al-lowed under with pharmacists scope of practice, in accordance with Federal law. (d) TARGETED INDIVIDUALS.-MTM services pro-

vided by licensed pharmacists under a grant awarded under subsection (a) shall be offered to targeted individuals who-

(1) take 4 or more prescribed medications (in

cluding over-the-counter and dietary supplements); (2) take any high risk medications; (3) have 2 or more chronic diseases, as identi

fied 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 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-deliv-ered MTM services, as the Secretary determines appro-priate. The Secretary, in collaboration with this group, shall determine whether it is possible to incorporate rapid cycle process improvement concepts in use in other Fed-eral programs that have implemented MTM services.

(f) REPORTING TO THE SECRETARY.-An entity that receives a grant under subsection (a) shall submit to the Secretary a report that describes and evaluates, as re-quested by the Secretary, the activities carried out under subsection (c), including quality measures endorsed under 399JJ, as determined by the Secretary.

(g) EVALUATION AND REPORT.-The Secretary

shall submit to the relevant committees of Congress a re

port which shall- (1) assess the clinical effectiveness of phar-macist-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 re-source of targeted individuals; (3) assess patient and prescriber satisfaction with MTM services; (4) assess the impact of patient-cost sharing requirements on medication adherence and rec-ommendations for modifications; (5) identify and evaluate other factors that may impact clinical and economic outcomes, includ-ing demographic characteristics, clinical characteris-tics, and health services use of the patient, as well as characteristics of the regimen, pharmacy benefit, and MTM services provided; and (6) evaluate of the extent to which partici-pating pharmacists who maintain a dispensing role

have a conflict of interest in the provision of MTM

services, and if such conflict is found, provide rec

ommendations on how such a conflict might be ap

propriately addressed.

(h) GRANT TO FUND DEVELOPMENT OF PERFORM-ANCE MEASURES.-Secretary may, through the quality measure development program under section 931 of the Public Health Service Act (as amended by this Act), award grants or contracts to eligible entities for the pur-pose of funding the development of performance measures that assess the use and effectiveness of medication therapy management services..