2018 Pharmacist Provider Status – Speculation and Action

I literally got the email this morning that a majority of senators support the 2018 Pharmacist Provider Status legislation!  This happens to be an incredibly timely post from an expert on provider status.

Dr. Jaclyn Boyle was kind enough to share some insight on 2018 Pharmacist Provider Status progress in the article below.  I met Jackie Boyle at ASHP in 2017 and she is my new go to connection for any updates on 2018 Pharmacist Provider Status.  She is an incredible pharmacist and staunch advocate for the profession. A little more about Dr. Boyle…

Jaclyn Boyle, PharmD, MS, MBA, BCACP, BCPS is an assistant professor and ambulatory care pharmacist. Her interests include innovation, interprofessional work, teaching, pharmacy organization involvement, and helping women in pharmacy. She created The Pharmacy Girl with the intention of empowering women in pharmacy to become the best version of themselves through personal and professional development.  – Take it away Jackie…

By now, I am sure you have heard that pharmacists are seeking provider status in the United States. But what does this mean for us?

The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S.109) is a bipartisan, identical bill that has been introduced in both the House and the Senate. H.R. 592 currently has 241 cosponsors (143 R, 98D) and S. 109 has 50 cosponsors (27 D, 22R, and 1 independent). This bill would allow pharmacists to be recognized as healthcare providers under the Social Security Act Currently, the following healthcare professionals are recognized as healthcare providers as defined by the Social Security Act:

  • Physicians

  • Physician Assistants

  • Nurse Practitioner/Clinical Nurse Specialist

  • Certified Nurse Midwife

  • Psychologist/Clinical Psychologist

  • Clinical Social Worker

  • Dietician

  • Occupational Therapist

  • Physical Therapist

By achieving provider status, pharmacists would finally have a mechanism to directly bill Medicare part B for their patients in medically underserved areas where there is a clear need for more healthcare. The Health Resources and Services Administration is the government agency that identifies what areas of the country are designated as “underserved”. Geographically speaking, the area of the country that is currently underserved is approximately 80% of the U.S. Pharmacists could be able to bridge gaps in access to care, lower the cost of medications and improve patient health outcomes, and redefine the role of the pharmacist across the country by coming up with new care delivery models if this legislation is enacted.

So, what can you do to move this forward? Let’s start with the most invasive and move on to the least invasive:

  1. Run for office! OK, realizing that this may be a far stretch for most of us, let’s move on to steps 2-5.

  2. Visit your legislator at their office. Whether that is on Capitol Hill or at their home office in your district, find a time to visit your representatives during their office hours. Recently, I had the chance to sit down with two of my state elected officials during their office hours and it was a one-on-one, undivided attention, focused time to discuss the issues that impacted me the most as well as the patients I serve. Don’t underestimate your ability to make change! Your elected officials want to hear from you as constituents.

  3. Invite your legislator for a site visit. This is a great relationship-building experience that can allow your legislator to see what it is that you do as a pharmacist on a daily basis and also provide an opportunity to discuss challenges and successes in your practice.

  4. Attend a town hall. This open forum is a little less invasive but may allow for some one-on-one time with your legislator for you to tell your story and discuss important legislative issues.

  5. Call or write to your legislators about what matters most. You can ask your federal legislators to support provider status through this easy-to-use form letter provided by the American Society of Health-System Pharmacists.

  6. Talk to others (anyone!) about what you do! Education is advocacy.

If you don’t advocate for your own profession, no one will do it for you. It may be our time in 2018! Considering that the bills had strong bipartisan support, the House bill reached a majority (and the Senate bill nearly did!), and that not many healthcare bills passed in 2017, 2018 could be the year that we achieve provider status in our profession. I hope you will consider joining me in the effort to move our profession forward!

3 Comments

  1. William Larson

    Great post as we get ready for Minnesota Pharmacy Legislative Day in Minnesota on February 27!

    Reply
  2. Emad

    So how was pharmacist billed for Medicare part B in underserved areas before that date …so we can understand the whole picture

    Reply
  3. Dr Anna Garrett

    I was part of the effort that began in 1996-97 to get provider status. It is ridiculous that we have been pushing this peanut up the hill for over 20 years. There are probably a lot of pharmacists that think this is a new effort. It is not. But it IS time to get it done for our patients and our profession.

    Reply

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Written By Eric Christianson

January 3, 2018

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