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February 11, 2015
Legislation Seeks to Designate Pharmacists as Part B “Healthcare Providers”
Washington, D.C.—A bill was introduced in the U.S. House of Representatives in late January to allow Medicare to reimburse pharmacists in medically underserved communities for a range of healthcare services. H.R. 592 was introduced by U.S. Reps. Brett Guthrie (R-KY), G.K. Butterfield (D-NC), Todd Young (R-IN), and Ron Kind (D-WI). During the last Congress, the bipartisan legislation, the Pharmacy and Medically Underserved Areas Enhancement Act, was supported by 123 bipartisan cosponsors. A day later, Senate Bill 314, the Pharmacy and Medically Underserved Areas Enhancement Act, was introduced by Sens. Charles Grassley (R-IA), Sherrod Brown (D-OH), Mark Kirk (R-IL), and Bob Casey (D-PA). While most states already allow pharmacists to provide additional services, such as immunizations, diabetes management, blood pressure screenings, and routine checks, no mechanism exists for pharmacists to be reimbursed for the work by the Medicare program. The legislation would formally designate pharmacists as healthcare providers under Medicare Part B. Doing that requires amending The Social Security Act of 1935 to enable pharmacists to provide services to Medicare beneficiaries in underserved communities that are already being provided for other patients under state law. Specifically, Medicare patients would gain enhanced access to pharmacists’ expertise and pharmacy services, including immunizations, diabetes screenings and self-management education, cardiovascular screenings and behavioral therapy, in states in which pharmacists are allowed to provide these services. The legislation focuses on medically underserved communities, as defined by the U.S. Department of Health and Human Services. Categories of underserved communities include elderly and rural populations, residents of public housing, areas with a shortage of primary care providers and with high poverty rates, and persons with HIV/AIDS, among others. “Whether it’s to inquire about medication, potential side effects, or discussing other ailments and complications, many patients depend on their local pharmacists,” Guthrie said. Butterfield noted that “allowing these qualified medical professionals to operate in underserved areas and receive payment for their services is a practical way to address the basic health care needs of vulnerable communities and the shortage in the delivery of care in those areas.” The bills are strongly supported by professional pharmacy groups. The American Pharmacists Association (APhA) “and the pharmacy profession are building on the momentum achieved in the last session of Congress,” Thomas E. Menighan, BSPharm, MBA, APhA’s executive vice president and CEO, noted recently. “Pharmacists are key members of the health care team, and when federal law recognizes our services, patients will have greater access to coordinated, quality health care.” A July Internet survey of likely voters who are informed and engaged when it comes to current events found that 79% favor the legislation—including 36% who strongly favor it. The survey, conducted by Public Opinion Strategies and commissioned by the National Association of Chain Drug Stores (NACDS), found the support cut across party lines, with 85% of Democrats and 76% of Republicans in favor. The Patient Access to Pharmacists’ Care Coalition (PAPCC), which was formed by supporting organizations to ensure all licensed pharmacists are able to care for Medicare patients to the full extent of state scope-of-practice laws, released a statement in strong support of the new legislation.
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