Will Part B Cover Services Pharmacists Have Provided During Pandemic?

Now that the COVID-19 pandemic has underscored how important pharmacists are to the nation’s healthcare system, advocates are making an effort to increased Medicare Part B coverage of services they already offer. A bill was recently introduced in Congress. Here are more details.

WASHINGTON, DC - COVID-19 pandemic has provided proof of how critical pharmacists are to the nation’s healthcare system, especially those in medically underserved areas.

Its legacy could be recognition of that.

The American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP) both praised the introduction of The Pharmacy and Medically Underserved Area Enhancement Act. The bill was introduced in late April by Rep. G.K. Butterfield (D-NC) and Rep. David McKinley (R-WV).

If it became law, pharmacists would be able to deliver Medicare Part B services that are already authorized by their respective state laws. Those services might include:

  • Medication management
  • Management of chronic conditions, such as diabetes and hypertension, and related medications
  • Cholesterol testing
  • Point of care testing (e.g., COVID-19, influenza, strep)
  • Immunization screening and administration not currently covered by Medicare Part B and D
  • Tobacco cessation services
  • Transition of care services

“The ongoing COVID-19 pandemic has further illustrated how difficult it is for some patients living in medically underserved communities to access care and achieve optimal medication therapy outcomes,” pointed out ASHP CEO Paul W Abramowitz, PharmD, ScD (Hon.). “This legislation recognizes that pharmacists can play an integral role in addressing these longstanding disparities and helps ensure that our most vulnerable patients can access the care they need.”

While the legislation does not expand scope of practice, according to advocates, it does place Medicare rules in alignment with existing authorities already granted to pharmacists by many states and health care organizations through credentialing and privileging programs.

Pharmacists not only are the most accessible healthcare providers, with nearly 90% of Americans living within five miles of one of the nation’s 88,000 pharmacies, but pharmacists have education and training comparable or better to other professionals delivering those services. A PharmD degree, for example, includes six years to eight years of higher education to complete. Yet, according to a pharmacy association press release, Medicare does not recognize and reimburse them for such services.

“In rural and underserved areas like those that I represent, access to a primary care doctor can be challenging and pharmacists often step in and serve as accessible access points for care.” Butterfield said. “Pharmacists can provide wellness testing, help manage chronic disease, and administer immunizations. The COVID-19 pandemic has highlighted how accessible pharmacists are and how they can be leveraged to improve the health of communities. Pharmacists in eastern North Carolina are helping people to live longer, healthier, and more fulfilling lives. But providing those services doesn’t come without a cost. ”

Scott J. Knoer, MS, PharmD, executive vice president and CEO of the American Pharmacists Association, added, “In many states across the country, pharmacists are already critical members of the health care team, and are compensated appropriately for that work. It’s time for Medicare to get with the program and recognize what many states have already learned – pharmacists provide great care.”

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