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Albertsons first to bill Medicaid for contraception consults

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BOISE, Idaho — Albertsons Cos. has become the nation’s first pharmacy chain to bill Medicaid for patient consultations about hormonal contraception.

The food and drug retailer said that as part of a collaborative effort to improve access to hormonal contraception for Oregon women, selected Albertsons Cos. pharmacies can now bill the state’s Medicaid plans for the consultation service fee.

Following the implementation of Oregon bill HB 2879, which allowed anyone 18 and older to receive birth control prescribed by a pharmacist, Albertsons and Oregon State University worked together to develop processes allowing pharmacists in the state to be paid by Medicaid for the consultation fee when prescribing birth control, eliminating the cost for the patient.

Albertsons pharmacyFor qualified women, hormonal contraceptives can be obtained in most Safeway or Albertsons pharmacies in Oregon.

“Oregon was the first in the nation to implement a law that gave women access to hormonal contraceptives through their local pharmacy,” Mark Panzer, senior vice president of pharmacy, health and wellness at Albertsons, said in a statement. “We are excited to be at the forefront with them to broaden patient access to health care services, decrease financial barriers, and add to ways that community pharmacists can directly and conveniently provide care for customers through the pharmacy.”

While the effort to set up billing through Medicaid for Oregon women is a milestone, the work is not complete.

“We are strategically expanding the service with Oregon insurance providers and pharmacy retailers to extend this billing capability for hormonal contraceptives,” according to Paige Clark, director of alumni relations and professional development at the Oregon State University OHSU College of Pharmacy. “Eventually, we anticipate all insurance plans will have processes in place to cover the pharmacist consultation service fee so that any woman in Oregon who wants birth control can have access to it, regardless of their financial constraints.”

No appointment is needed to obtain hormonal contraceptives through a pharmacist. The patient completes a self-assessment questionnaire and meets with the pharmacist in a private area to discuss her information and personal contraceptive needs. If the patient’s self-assessment information and blood pressure are acceptable, the pharmacist creates the written prescription, counsels the patient and dispenses the medication in pill, patch, ring or depo form, depending on state regulations. The process takes about 15 minutes.

Billing involves two transactions: one for the medication and another for the consultation service fee. Insurance already covers the cost of birth control medication. The pharmacist consultation service fee, now covered by Medicaid, is reimbursed at the same rate as that for medical doctors, doctors of osteopathy, nurse practitioners and physician assistants. If a patient does not have insurance, she has the option to pay cash for the consultation service and can discuss with the pharmacist what low-cost contraceptive choices are available to her.

Limitations to women obtaining hormonal birth control directly from a pharmacist may include high blood pressure, certain health conditions, and contraindications to the hormonal contraceptive therapy.

The new billing follows another first in the pharmacy realm for Albertsons: pharmacy technicians giving immunizations. That resulted from a collaboration between the retailers and Washington State University College of Pharmacy on a pilot program to provide immunization training for pharmacy techs.

Aimed at expanding patient access to health care services, the pilot led to the first law allowing pharmacy technicians to administer vaccinations, Albertsons said. In turn, that led to an Albertsons pharmacy technician being the first Rx technician in the United States to give a shot to a patient.


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