The Medicare Modernization Act of 2003 requires prescription drug plans to provide medication therapy management services to eligible Part D beneficiaries. In 2010, in an attempt to increase consistency among programs, the Centers for Medicare and Medicaid Services (CMS) expanded the regulatory requirements associated with medication therapy management (MTM). After evaluating the outcomes of MTM since its implementation in 2006, CMS concluded that the program has fallen short of expectations. On implementation of MTM, CMS projected that 25 percent of Medicare beneficiaries would qualify for MTM based on the proposed eligibility criteria. In reality, the percent of MTM eligible beneficiaries has fallen far below that approximation. Among members who meet eligibility criteria, MTM completion rates remain around 20 percent, on average. CMS also notes that certain racial and ethnic disparities continue to exist in MTM eligibility. Specifically, African American and Hispanic beneficiaries are less likely to meet eligibility criteria when compared with their Caucasian counterparts. These identified shortcomings related to MTM delivery within the Part D population remain unresolved. In order to target beneficiaries that will benefit most from MTM services, and ensure optimal outcomes in all MTM delivery settings, our recommendations to CMS are as follows: CMS should incorporate medication adherence measures into annual MTM eligibility criteria; CMS should require that plan sponsors adhere to the industry standard of including at least 25% of their total Part D population in MTM programs; CMS should include MTM outcomes data in the determination of health plan star ratings and reimbursement structures; and CMS should require health plans and affiliated healthcare organizations to grant MTM providers access to patients’ electronic medical records.