Industry Voices—Federal rules limit availability of testing across America

As COVID-19 surges across the nation, large swaths of America’s underserved and rural communities suffer from a shortage of healthcare providers, which seriously impedes sufficient testing.

Yet we have more than 300,000 licensed pharmacists across the country who could help rapidly expand access to testing and eventually to a vaccine—if our Medicare system provided reimbursement for pharmacists to administer these vital services to seniors.

Congress has the power to immediately eliminate this bureaucratic obstacle that needlessly prevents delivery of care. Currently, every state allows pharmacists to administer COVID-19 tests, the proven strategy for controlling the disease. However, the federal government will not pay most pharmacies to administer COVID-19 testing for Medicare beneficiaries.

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A recent analysis found that 54% of U.S. counties—including 68% in rural America—do not have a single COVID-19 testing site. What’s more, 58% of U.S. counties with testing sites do not have sufficient capacity to meet recommended testing levels, though many places could be utilizing convenient testing from local pharmacists.

In rural and underserved communities, residents must drive twice as long as their urban counterparts to reach a hospital, while 90% of all Americans live within 5 miles of a community pharmacy (PDF).

Failure to provide adequate access to testing jeopardizes the safety of both patients and our healthcare workers. The U.S. is currently conducting about a half million tests per day, but a new analysis from the Harvard Global Health group found that 4.3 million tests per day are required in order for our country to achieve suppression of COVID-19.

In April, Department of Health and Human Services (HHS) Secretary Alex Azar authorized licensed pharmacists to order and administer COVID-19 tests. This action from HHS acknowledged how pharmacists can help during this emergency with point-of-care testing, but the lack of Medicare reimbursement undermines access to these services for those who are the most vulnerable to the virus.

That’s just our current challenge. When a COVID-19 vaccine eventually becomes available, we will face another potential logistical nightmare in providing vaccinations to all corners of this vast nation. Congress should also have the foresight to prepare right now by ensuring that we are able to deploy trusted pharmacists to provide these desperately needed services.

To ensure that we are ready to tap into this resource, provisions to allow Medicare to fully utilize our pharmacy workforce for both testing and vaccinations should be included in the next round of pandemic response legislation. We must care for those at the greatest risk of COVID-19 mortality, particularly our older patients and those in underserved, rural and frontier communities.  

Congress can reduce the risk of COVID-19 community spread and limit COVID-19’s negative health and financial impact on health systems and patients. We know how.

We must expand COVID-19 testing for Medicare beneficiaries by allowing them to access testing from pharmacists in their community. Congress should also act preemptively to authorize reimbursement of pharmacists for COVID-19 vaccination so that when a vaccine becomes available, our nation will not face immunization delays like the current testing delays.

Tom Kraus is vice president of government relations for the American Society of Health-System Pharmacists and former chief of staff at the Food and Drug Administration.