Provider status: Important to pharmacists, critical to patients


Validation through inclusion in Medicare Part B could lead to recognition of pharmacists as healthcare providers across the board.

Stacie MaassIf you had asked most pharmacy professionals a year ago about the possibility of bipartisan, bicameral federal legislation recognizing pharmacists and their patient-care services, a likely answer would have been, “I hope so.” Today, slightly more than a year after the profession’s most recent push for federal legislation, we have a lot more than hope about which to be excited.

See also: APhA urges members to fight for provider status

Our profession is unified as never before in the pursuit of expanded patient access to pharmacists and their patient-care services. A strong collaboration was formalized in early 2014, when national pharmacy organizations, representing the breadth of our profession, formed the Patient Access to Pharmacists’ Care Coalition (PAPCC). Now, this year-old coalition comprises nearly 30 organizations that represent patients, pharmacists, pharmacies, and other interested stakeholders.

Building on last year’s momentum, we began 2015 and a new Congressional session with the introduction of the Pharmacy and Medically Underserved Areas Enhancement Act - H.R. 592/ S. 314 - in the House and Senate. Just like the last year’s House legislation (H.R. 4190), the Act would enable patient access to, and payment for, Medicare Part B services delivered by state-licensed pharmacists in medically underserved communities.

Help for the underserved

While the successful passage of H.R. 592/ S. 314 is a priority for our profession, it is absolutely critical to our patients. The legislation is about increasing access to healthcare for some our most vulnerable citizens - patients in medically underserved communities, especially seniors. Patient access to healthcare is a real issue across the United States. It is expected to worsen with a projected shortage in primary care providers, more insured individuals entering the healthcare system, and a continually aging population.

For decades, pharmacists have been among the few health professionals who lack recognition under federal law. As healthcare becomes increasingly complex and medication use rises, federal law must keep up and recognize the vital role pharmacists play in coordinated care delivery. H.R. 592/ S. 314 will give patients greater access to healthcare through pharmacists’ patient-care services, allow pharmacists to work more closely with other healthcare professionals to manage chronic conditions, help patients transition among healthcare settings, and optimize medication use. While the legislation targets Medicare beneficiaries in medically underserved communities, many state and private health plans often cite the omission from Medicare Part B as a reason for lack of coverage of pharmacists’ patient-care services. The American Pharmacists Association (APhA) believes this legislation will provide the business infrastructure to support pharmacists in meeting the healthcare needs of all patients.


State-level efforts matter

Passage of federal legislation alone will not address all the existing barriers that prevent patients from benefiting from the gamut of services pharmacists can provide. In addition to federal efforts, our profession is pursuing state-level and private sector change. Successes occurring in those arenas deliver real-life examples of pharmacists’ value and provide additional momentum to our legislative pursuits. The federal government and other payers are slowly but surely realizing what our patients and other health professionals already know: Pharmacists are highly educated and trained healthcare providers, and when pharmacists are on the patient’s healthcare team, access increases, quality improves, and costs go down.

See also: State associations, APhA discuss provider status

It is truly an exciting time, not only for our profession but also for the patients we serve. Your involvement is critical to the success of this profession-wide initiative. Both APhA and PAPCC will need you as this effort moves forward. Letters to your members of Congress need to be written. Stories of what provider status would do for your patients need to be told. Get ready - your pharmacy organizations will be calling on you in the coming months to do your part!

For more information about our efforts towards federal, state and private sector recognition, or to learn how to get involved in this exciting and historic campaign, visit

Stacie Maass is senior vice president, Pharmacy Practice and Government Affairs, American Pharmacists Association.

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