SMART RETAILING RX BLOG

3 actions you can take to gain provider status

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Pharmacist involvement is crucial

In brief:

  • State and national legislation is moving forward for granting pharmacists provider status.
  • This legislation outlines clinical services pharmacists can provide and may increase opportunity for new revenue streams.
  • Pharmacists must align and work with other groups to gain support for provider status legislation.
  • Each independent pharmacist can act on multiple fronts to support the legislation.

With declining reimbursement rates, the ability of pharmacists to be paid for providing clinical services has become even more important.

To do that, however, state and federal laws are needed that grant pharmacists provider status and the ability to be paid for clinical services, including medication therapy management (MTM) and patient education.

Progress in the states

In recent years California, Washington, Oregon and North Dakota all have passed laws granting provider status to pharmacists, and those laws are still taking effect. Just this spring, for example, California pharmacists gained the ability to provide birth control directly, under a law that passed in 2013.1

The action is ongoing in dozens of states.2 Sometimes, state laws address only a narrow category of care. Michigan, for example, now allows pharmacists to dispense and bill for injectable psychiatric medications.3 (See the American Pharmacists Association’s Pharmacists Provide Care campaign to learn what is happening in your state.)

Movement at the federal level

Federal legislation granting pharmacist provider status in underserved areas has gained bipartisan support in the Pharmacy and Medically Underserved Areas Enhancement Act, HR 592 and S 314.4

Pharmacists’ critical role

Pharmacists need to be involved in shaping how legislation is written and ensure that it has enough support to become law. Here are three ways that independent pharmacists can make a difference in the drive for provider status.

  1. Understand the issues. Educate yourself about pending legislation that could affect your pharmacy practice and about how other states have dealt with similar issues. Numerous pharmacy associations are active on these topics and can provide a wealth of information. Think about what changes would improve your ability to provide care to patients and what it would take to remove any barriers.
  2. Build relationships. Pharmacists can’t make these changes alone. To gain support, reach out to elected representatives, network with other pharmacists, and talk with physicians, patients, and others affected by the legislation. (See “Independent Pharmacies Take Action to Impact Legislation.”) If you are a McKesson customer, check out the Legislative Action Center.
  3. Share your stories. Shatter the image that all pharmacists do is count pills. Take every opportunity to show how you serve patients and the community in a wide variety of ways. Speak at a business luncheon about the valuable clinical services that independent pharmacies offer, invite elected representatives to your pharmacy, talk with local media about your flu shots at workplaces, and post on social media. A pharmacy student who created the “Pharmacists of Michigan” Facebook page said that people often make comments such as, “Pharmacy is much more than I thought it was.”5

Even after legislation passes, pharmacist involvement is crucial in the rulemaking process to ensure the way the law is applied actually works well for pharmacists and patients. Being involved with your state board of pharmacy and state pharmacy association can give you a voice in that process.

 

1 “What You Need to Know about California’s New Birth Control Law,” Soumya Karlamangla, Los Angeles Times, April 8, 2016. LINK
2 “More States Address Pharmacists’ Provider Status Recognition,” Kristalyn K. Weaver, Pharmacy Today, April 1, 2015. LINK
3 “Pharmacists Provide Care Champions,” American Pharmacists Association. LINK
4 “The State of Provider Status: An Update for Pharmacy Students,” Ryan Marotta, Pharmacy Times, February 22, 2016. LINK
5 “’Pharmacists of Michigan’ Tells Their Stories to Advocate for Profession,” Rachel Balick, Pharmacy Today, April 26, 2016. LINK