Inside This Issue - News
Push to secure provider status for pharmacists advances
April 7th, 2014
WASHINGTON – Congress is considering legislation that would give pharmacists expanded recognition as health care providers.
Reps. Brett Guthrie (R., Ky.), G.K. Butterfield (D., N.C.) and Todd Young (R., Ind.) last month introduced H.R. 4190, which aims to widen the scope of health services that pharmacists provide via Medicare. The bill would amend Title XVIII of the Social Security Act to enable pharmacists to be reimbursed under Medicare Part B for certain health services in medically underserved communities.
“This simple bill would benefit millions of seniors across the country and particularly those that live in rural and underserved areas,” Butterfield said when introducing the legislation. “Expanding patient access to primary care through trained, qualified and licensed pharmacists, while also addressing the shortage in the delivery of care, is basic supply and demand.”
Many states allow pharmacists to provide health services beyond prescriptions — such as immunizations, diabetes management, blood pressure screenings and routine health checks — but there’s no mechanism for reimbursing pharmacists for these services under Medicare, the lawmakers noted. They said this “commonsense bill” enables pharmacists to be reimbursed for services they are already allowed to perform, when administered in medically underserved areas.
“I routinely hear from Kentuckians who rely on their pharmacists as their initial access point to health care,” Guthrie commented. “Whether it’s to inquire about medication or potential side effects or discussing other ailments and complications, many patients view their pharmacist as a critical member of their health care team. This legislation will increase patient access to basic services in a cost-effective and responsible way.”
Pharmacy trade groups hailed the proposed legislation. The National Association of Chain Drug Stores said the bill would designate pharmacists as health care providers in Medicare. “The provider status designation will amplify pharmacists’ ability to do what they do best: serve patients and help them on the road to better health,” stated NACDS president and chief executive officer Steve Anderson.
Pharmacists have been limited in the number and types of services they can perform because they haven’t been recognized as health care providers by third-party payers, including Medicare and Medicaid, according to NACDS.
“Combined with their expertise and training, pharmacists as health care providers can serve their patients to their full capabilities,” Anderson added. “Expanding the role of pharmacists to meet the demands of more than 30 million newly insured patients can only help alleviate the increased need for health care services. We are hopeful that this legislation is the first step toward the ultimate goal of achieving success for patient health.”
The National Community Pharmacists Association (NCPA) said H.R. 4190 would expand health care access by allowing state-licensed pharmacists in traditionally underserved communities to participate in and be reimbursed for more services via Medicare Part B. “Community pharmacists are ideally positioned to play a greater role in health care, so NCPA is proud to support this legislation,” stated NCPA CEO B. Douglas Hoey.
Measures to recognize pharmacists as health care providers and expand their scope of services are already under way in some states.
This past fall California enacted a law that authorizes its state pharmacy board to recognize an “advanced practice pharmacist,” expanding pharmacists’ ability to collaborate with other members of a patient’s health care team. Pharmacists with that designation can perform physical assessments, order and interpret medication-related tests, and refer patients to other providers.
In Massachusetts, pending legislation would grant pharmacists provider status. A state House bill (H. 2060) would classify pharmacists as health care providers, but it doesn’t address compensation for services. Meanwhile, a Massachusetts Senate bill (S.484) would deem pharmacists to be health care providers and set benefits for services rendered under a collaborative practice agreement.
Other states — including Florida, Ohio, North Carolina, Minnesota, Iowa, Vermont and Mississippi — have specified health services for which pharmacists can be reimbursed but haven’t recognized them as health care providers under statute, according to the American Society of Consultant Pharmacists.