Provider Status Bill Focuses on Underserved, Earns NACDS’ Backing

Bipartisan House bill seeking to designate pharmacists as healthcare providers in Medicare leverages pharmacists’ education and training

Arlington, Va. – Bipartisan legislation was introduced in the U.S. House of Representatives today that would designate pharmacists as healthcare providers under the Medicare program.  The bill would amend The Social Security Act of 1935 to enable pharmacists to work to their full capability by providing underserved patients in the Medicare program with services not currently available to them.

H.R. 4190, introduced by Reps. Brett Guthrie (R-KY), G.K. Butterfield (D-NC) and Todd Young (R-IN), would elevate pharmacists’ ability to help patients achieve success in their healthcare.  Specifically, Medicare patients could have enhanced access to pharmacy services including immunizations, diabetes screenings and self-management education, cardiovascular screenings and behavioral therapy within the scope of state laws under this new bill.

“The provider status designation will amplify pharmacists’ ability to do what they do best – serve patients and help them on the road to better health,” said NACDS President and CEO Steven C. Anderson, IOM, CAE.

“We applaud the leadership of Reps. Guthrie, Butterfield and Young in introducing this bipartisan, commonsense legislation,” said Anderson.  “As one of the most trusted healthcare professionals, pharmacists are extremely valued by patients in the greatest of need. From helping patients take their medications effectively and safely, to providing preventive services, pharmacy services help keep people healthier and reduce costs.”

The U.S. healthcare system is on a transformational path and it is becoming increasingly challenging to ensure access to affordable, quality patient care – especially for the medically underserved, including senior, residents of public housing, persons with HIV/AIDS, as well as rural populations and many others.  The national physician shortage, at a time when health insurance coverage is expanding, could further complicate healthcare access.

In recent years, pharmacists have played an increasingly important role in the delivery of healthcare services.  Pharmacists now commonly provide immunizations and medication therapy management (MTM) services.  They are also developing new and innovative approaches through medication synchronization programs, identifying and treating medication adherence issues, and working to have the ability to provide simple medical testing services.

However the lack of pharmacist recognition as a provider by third party payors – including Medicare and Medicaid – has limited the number and types of services pharmacists can provide, even though fully qualified to do so.

Today’s pharmacists spend more than six years obtaining professional education to receive their degree and license.  In addition to providing safe access to prescription medications, pharmacists provide one-to-one, face-to-face to counsel patients about the importance of taking those medications as prescribed. They also administer vaccinations – including flu shots, provide preventive health tests and offer educational programs and services to help patients manage diseases and chronic conditions.

Many patients in the Medicare Part B program also rely on their pharmacists to provide durable medical equipment and other supplies to help them manage chronic diseases or conditions.

“Retail pharmacies are oftentimes the most readily accessible healthcare provider.  Research has shown that nearly all Americans (89%) live within five miles of a community retail pharmacy,” said Anderson.  “Combined with their expertise and training, pharmacists as healthcare providers can serve their patients to their full capabilities.

“Expanding the role of pharmacists to meet the demands of more than 30 million newly uninsured patients can only help alleviate the increased need for healthcare services.  And we are hopeful that this legislation is the first step towards the ultimate goal of achieving success for patient health.”