Washington insurers to recognize provider status

Washington insurers to recognize provider status

A groundbreaking bill signed into law May 11 in Washington state is the first in the country to require health insurance carriers to include pharmacists as network providers.

Until now, payers recognized pharmacists only for dispensing medications, avoiding direct reimbursement for services such as chronic disease management, immunizations, and MTM, which pharmacists have been providing for years within clinics and hospitals. S.B. 5557 requires health insurance carriers to recognize pharmacists as they do other providers.

See also: Pharmacist provider status gains traction

Above and beyond

Jeff Rochon“It allows pharmacists to go above and beyond dispensing, to administer medications, monitor drug therapy and use, and initiate or modify drug therapy in coordination with collaborative drug therapy agreements with prescribers,” said Jeff Rochon, CEO of the Washington State Pharmacy Association (WSPA).

“We are excited that pharmacists will have opportunities to increase collaboration within the healthcare team in patient-centered medical homes and accountable care organizations, with the focus being on quality and safety,” Rochon said.

The new law requires health plans to reimburse pharmacists in clinics and hospitals starting January 1, 2016; for community pharmacists, reimbursement will begin January 1, 2017.

“Health plans that delegate credentialing agreements to contracted healthcare facilities must accept credentialing for pharmacists employed or contracted by those facilities. Health plans must reimburse facilities for covered services provided by network pharmacists within the pharmacists’ scope of practice per negotiations with the facility,” the law states.

The bill passed after several years of hard work by the WSPA, the Washington State Medical Association, the Washington State Hospital Association, and other groups. Senator Linda Parlette, Rep. Shelley Short, and Don Downing, clinical professor at the University of Washington School of Pharmacy, were also instrumental in getting the legislation passed, according to Rochon.

“We are hopeful that this advancement in our state can be utilized to help other states,” Rochon said.

Drug Topics ranked No. 1 among retail pharmacists

UBM Medica is pleased to announce that Drug Topics is considered to be the most thoroughly read resource among retail pharmacists, according to the 2015 Kantar Media Readership study. The results were announced last month.

Every year, Kantar Media surveys pharmacists to measure the frequency and thoroughness with which they read print and digital publications in the pharmacy field. To assess how thoroughly they read the publication (average page exposures), survey participants describe their reading habits as “cover-to-cover,” “articles of interest,” “table of contents,” or “skim the issue.”

According to the 2015 study, Drug Topics is ranked as No. 1 in average page exposures among retail pharmacists, No. 1 in average page exposures among retail pharmacy chains, No. 1 in average page exposures among owners and managers at retail pharmacies, No. 1 in cover-to-cover readership among retail pharmacy publications, and No. 1 in high readership among retail pharmacists.

Serving readers for 159 years

Drug Topics would like to thank our readers for their loyalty and engagement, our pharmacy contributors for their expertise and dedication to the profession, our advisory board members for their editorial guidance throughout the year, and our advertisers for their ongoing support in delivering quality content to pharmacists in all practice settings.

“For nearly 160 years, pharmacists have turned to Drug Topics to help navigate the changing healthcare landscape and improve outcomes for patients,” said Mike Weiss, group publisher of Drug Topics. “These results demonstrate that retail pharmacists consider Drug Topics to be their go-to resource for the information they need, when they need it.”

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