What Is Provider Status?
Despite being considered as “medication experts” and regarded among the most knowledgeable, trusted, and accessible health care providers within our current health care system, pharmacists have never received formal recognition as health care providers under federal law. Nearly all other health care professional services are covered under Medicare laws, including services provided by essential health care providers, such as physicians, nurses, chiropractors, midwives, dieticians, and many others. However, services provided by pharmacists continue to remain noticeably absent.
|“The primary goal of this effort is to expand medically-underserved patients’ access to pharmacist services consistent with state scope of practice law.”
Many of our national pharmacy organization have teamed up to form the Patient Access to Pharmacists’ Care Coalition (PAPCC). This coalition is working together to call on Congress to pass the Pharmacy and Medically Underserved Areas Enhancement Act (known as HR 592 and S 314) that would amend section 1861(s)(2) of the Social Security Act to enable Medicare beneﬁciaries to access pharmacist-provided services under Medicare Part B. State pharmacists associations like TPA continue to work locally with our elected officials to support these federal-level efforts.
Why Is Provider Status Needed?
The primary goal of this effort is to expand medically-underserved patients’ access to pharmacist services consistent with state scope of practice law. Additionally, many state and private health plans often cite the omission from Medicare Part B as a reason for lack of coverage for beneficiaries or lack of compensation of pharmacists for providing comprehensive, patient-centered care. Omission from Medicare Part B can also result in barriers to optimizing the use of pharmacists’ patient care services in emerging integrated care delivery models promoted by the Affordable Care Act (ACA), such as medical homes and accountable care organizations (ACOs), which are located in another section of the SSA.
Key Aspects of the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592 and S. 314):
- Increases access and improves patient outcomes by enabling pharmacists to provide patient care services, consistent with their education, training and licenses.
- Promotes increased access to care for patients who are medically underserved.
- Promotes cost-effective health care by increasing access to, and opportunities for, early intervention at cost-effective settings.
How You Can Engage – It’s Never Been Easier!
Through our new automated T-PLAN system, TPA has been able to speed up and simplify the process of contacting your legislators! Armed with only your address, our automated system will 1) identify your legislators, 2) determine whether or not they’re already signed on to the legislation we’re supporting, and 3) send them a personal message directly from you, either requesting their support or thanking them for it. A sample message will be provided, which you can edit as you see fit or send as-is. Ready? CLICK HERE to get started!
Efforts in Tennessee to Maximize Pharmacists’ State Scope of Practice:
Resources for Pharmacists and Student Pharmacists:
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