Increase access to pharmacists’ patient-care services: recognize pharmacists as providers under Federal Law and pass H.R 592 and S. 314

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Pharmacists provide an array of patient-care activities that have shown through numerous studies, to improve patient outcomes. The most comprehensive report coming in the form of a 2011 report to the U.S. Surgeon General, “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice”. Several states have Clinical Pharmacists who provide direct patient care through a variety of services, such as managing a patient’s medication regimen, ordering labs, and adjusting mediation dosages. The ability of a pharmacist to perform these expanded patient care duties are largely due to Pharmacist Collaborative Practice Agreements (CPA) with providers, which differs from state to state. Even with the ability of pharmacists to have expanded scope of practice, they are still not recognized as Providers under Medicare Part B and the Social Security Act. This inhibits pharmacists from fully being integrated within the healthcare team, as they are not being reimbursed for the services they are providing. By seeking provider status, pharmacists are seeking recognition for reimbursement. Once reimbursement is uniform for the array of services pharmacists can provide, it can increase patient access to pharmacist care. Although there are 34 states that recognize pharmacists as providers, third party reimbursement is highly variable and even non-existent in some states. The American Pharmacists Association state that “because Medicaid and private payers often follow precedents set by Medicare, federal provider status for pharmacists within the Social Security Act (SSA) would likely make coverage for pharmacists’ patient care services easier and more widespread”.

Essentially, pharmacists need to be utilized to the top of their ability in order to promote positive patient outcomes. A way to do this is by recognizing pharmacists as providers by Medicare Part B within the Social Security Act. Once national precedent is set, then Medicaid and other private payers will most likely follow. Support from the general public and by various healthcare professions are needed to support the Pharmacist Provider Status Legislation, called the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592 and S. 314).

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One Response to “Increase access to pharmacists’ patient-care services: recognize pharmacists as providers under Federal Law and pass H.R 592 and S. 314”

  1. kathrynharlow Says:

    Great blog! I agree that many pharmacists are providing patient-care without appropriate reimbursement or provider status. However, I also wonder what the role large conglomerate drug stores play in influencing government decisions. As a pharmacy technician at Walgreens, I saw the conflicts between pharmacists administering flu-shots and the corporate decision makers enforcing quotas based solely on profit margins. The pharmacists were paid the same hourly wage with increased work loads, while the corporations profited hugely from billing Medicare part B for services as well as part D for the “medication” (the vaccine itself). Would this discrepancy in reimbursement between pharmacist vs corporation be addressed if Medicare Part B recognized all pharmacists as health care providers?

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