State governments are increasingly calling on pharmacists to provide patients with access to essential healthcare services -- from COVID-19 testing to patient counseling and administration of certain drugs. Unfortunately, the Medicare program has not kept pace with state scope of practice and does not reimburse pharmacists for providing these patient care services. As a result, Medicare beneficiaries have less access to needed care that pharmacists are licensed to provide, even when services are within a pharmacist’s scope of practice in their state.
How to Protect Patients – ASHP is Working to:
- Support passage of provider status legislation recognizing pharmacists as healthcare providers under Medicare Part B, which would give Medicare patients access to healthcare services delivered by pharmacists, such as testing for infectious diseases, ordering smoking cessation products, and providing comprehensive medication management services (CMM).
- Encourage the Department of Health and Human Services to make COVID-19 regulatory flexibilities permanent so that patients can continue to receive expanded pharmacist services after the public health emergency ends, including pharmacist-provided testing, vaccinations, and telehealth services.
- Advocate for the Centers for Medicare & Medicaid Services to create pharmacist payment codes for reimbursement to patient services provided incident to a physician that includes reimbursement for CMM.
- Encourage state legislators and regulators to follow the lead of innovative states through legislation that requires Medicaid and private payers to recognize and cover pharmacists in healthcare provider networks.
Provider Status Resources
- ASHP Along with Hospitals and Health Systems Send Letter of Support to Congress pdf
- ASHP and Other Healthcare Organizations Send Letter of Support to Congress pdf
- Pharmacy and Medically Underserved Areas Enhancement Act
- How to Talk to Policymakers
- Podcast: A Discussion on the Reintroduction of Provider Status Legislation
- 2021 State Provider Status Legislation Midyear Review
- Additional Provider Status Resources
Provider Status News
- More Than 130 Healthcare Groups Express Support for Legislation Expanding Medicare Patients Access
- U.S. Senate Joins House in Sponsoring Legislation Expanding Medicare Patients' Access to Pharmacist Services
- Pharmacy Associations Applaud Introduction of Bill Expanding Medicare Patients' Access to Pharmacist Services