Regulatory Requirements and Credentialing for Pharmacy-Based Point-of-Care Testing

Opinion
Video

A panelist discusses how obtaining a Clinical Laboratory Improvement Amendments (CLIA) waiver is an essential regulatory step for pharmacies to perform point-of-care testing, followed by credentialing with payers to receive reimbursement for these services.

Regulatory Framework and Credentialing

Main Discussion Topics:

  1. CLIA waiver requirements and regulatory compliance
  2. Pharmacist credentialing process with payers
  3. Documentation and protocol development importance

Key Points for Physicians:

  • 48 states allow pharmacists to perform point-of-care testing
  • Pharmacy testing requires CLIA waivers
  • Pharmacies must establish protocols similar to those in medical practice settings

Notable Insights:

  1. Credentialing is a one-time process that creates ongoing opportunity
  2. Creating standardized documentation during initial implementation simplifies future onboarding
  3. State health departments often provide guidance and support for implementing testing programs

Clinical Significance:

Although regulatory and credentialing processes require an initial investment of time, they establish the foundation for pharmacy-based clinical services that can expand health care access points and create sustainable revenue streams through formalized medical billing pathways.

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