OBJECTIVES: Non-Hispanic Blacks and Hispanics are less likely than non-Hispanic Whites to be eligible for U.S. Medicare medication therapy management (MTM) services. The objectives for this study were to determine (1) racial/ethnic disparities in meeting MTM eligibility criteria as stipulated in the Patient Protection and Affordable Care Act (PPACA); and (2) whether there would be greater disparities in health/economic outcomes among MTM-ineligible than MTM-eligible groups (if so, the PPACA MTM eligibility criteria may aggravate existing disparities in these outcomes). METHODS: Medicare Current Beneficiaries Survey (2007-2008) was analyzed. PPACA MTM eligibility was compared between Whites and minorities using logistic regression. Various other regression models were used for other study outcomes (measures for health status, health services utilization/costs and medication utilization patterns). To determine difference in disparities across MTM eligibility categories, interaction terms were included between dummy variables for race/ethnicity and MTM eligibility and were interpreted on the multiplicative term and using marginal effects. RESULTS: The sample consisted of 12,966 Medicare beneficiaries (weighted to 51,635,149). Blacks and Hispanics were less likely than Whites to meet PPACA MTM eligibility criteria (adjusted odds ratio [OR]=0.66 [P<0.05] for Blacks, and OR=0.62 [P<0.05] for Hispanics). Racial and ethnic disparities in self-perceived health status (SPHS), activities of daily living (ADLs), and instrumental ADLs were greater among the MTM-ineligible than the MTM-eligible populations (e.g., for SPHS, difference in marginal effects between Whites and Blacks=27.25 [P<0.01] across MTM eligibility categories, and between Whites and Hispanics=20.62 [P=0.03]). Disparities were smaller in number of chronic conditions and number and costs of physician visits among MTM-ineligible compared to MTM-eligible populations. No other variables exhibited significant interaction effects. CONCLUSIONS: The PPACA MTM eligibility criteria is not an ideal alternative in resolving disparity issues associated with Medicare MTM eligibility criteria. MTM eligibility criteria which reduce rather than aggravate disparities have yet to be identified/devised.