OBJECTIVES: Racial and ethnic disparities were found in meeting Medication Therapy Management (MTM) eligibility criteria implemented under Medicare Modernization Act (MMA). Therefore, the objective is to examine whether an alternative MTM eligibility standard based on Medicare Part D Star Ratings system can reduce racial and ethnic disparities. METHODS: The study analyzed 2012-2013 Medicare claims data for 3 million beneficiaries. Patients were considered MTM-eligible if they had any issues with measures of medication utilizations in Star-Ratings. Logistic regression and Blinder-Oaxaca approach were used to test disparities in meeting eligibility criteria of Star-Ratings across racial/ethnic groups. Multinomial logistic regression was used to examine whether there was disparity reduction by comparing individuals who were MTM-eligible under MMA but not Star-Ratings and those who were MTM-eligible under Star-Ratings but not MMA. Disease-specific analysis was conducted for each of the top ten MTM-targeted chronic conditions. Main and sensitivity analyses were conducted for MMA-based thresholds (used in 2009 and 2013 by Part D plans, and proposed for 2015 by the Centers for Medicare & Medicaid Services) and Star-Ratings measure combinations. RESULTS: Adjusted odds ratios to non-Hispanic Whites (Whites) were 1.394 (95% Confidence Interval (CI)=1.375-1.414) for non-Hispanic Blacks (Blacks) and 1.197 (95% CI=1.176-1.218) for Hispanics, indicating likelihood of MTM eligibility under Star-Ratings 39.4% higher among Blacks and 19.7% higher among Hispanics than Whites. Disparities were not completely explained by difference in patient characteristics based on Blinder-Oaxaca approach. Multinomial logistic regression found significant racial and ethnic disparity reduction in main analysis, e.g., Black-White and Hispanic-White disparities in MTM eligibility were reduced by 55.1% (Relative Risk Ratios (RRR)=0.449, 95% CI=0.434-0.465), and 45.6% (RRR=0.544, 95% CI=0.521-0.569), respectively, when using Star-Ratings compared to 2013 MMA criteria. Similar patterns were found in sensitivity and disease-specific analyses. CONCLUSIONS: Star-Ratings criteria would reduce racial and ethnic disparities in the general Medicare population and those with specific chronic conditions.