New bill aims to pay pharmacists under Medicare for providing health services

Pharmacy
New legislation aims to pay pharmacists under Medicare for providing care to medically underserved communities. (Getty/jacoblund)

A new House bill aims to reimburse pharmacists under Medicare for providing services in medically underserved communities.

The bill, introduced Thursday, enables pharmacists to deliver Medicare Part B services already authorized by state laws.

“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,” said Rep. G.K. Butterfield, D-North Carolina, one of the co-sponsors, in a statement. “Pharmacists can provide wellness testing, help manage chronic disease and administer immunizations.”

The services a pharmacist would be able to get reimbursed for include transition of care services, cholesterol tests or other tests for flu and COVID-19. Another service includes immunization screenings not currently covered under Part B or Part D.

Pharmacists that perform the services would get paid 80% of the physician’s Medicare rate for the same services.

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Some states have already allowed pharmacists to get reimbursed under Medicaid for several services.

The legislation was introduced in Congress a few years ago but never advanced. Advocates say there are several factors that could improve its chances now.

“We have huge inequities in healthcare and a major spotlight on that which there should be,” said Scott Knoer, executive vice president and CEO of the American Pharmacists Association, in an interview with Fierce Healthcare.

The Biden administration has made addressing racial inequities in healthcare a major priority in its healthcare agenda.

This legislation should help address those inequities.

“The biggest problem keeping pharmacies from serving patients in any area is we have a horrible issue of how we are renumerated,” Knoer said.

Another key factor is the COVID-19 pandemic, which has increased visibility among the public on the various services that pharmacists can provide besides dispensing drugs, he added.

“The public never really understood what pharmacists did,” Knoer said, adding that pharmacists are playing a major part in providing COVID-19 vaccinations.

But the legislation is likely to get stiff opposition from the American Medical Association (AMA), which has traditionally opposed legislative and regulatory efforts to expand scopes of practice for nurse practitioners, pharmacists and other healthcare personnel.

For example, AMA opposed a declaration from the Department of Health and Human Services back in August that allowed pharmacists and pharmacy interns to administer vaccines to children between 3 and 18 years old. AMA President Susan Bailey, M.D., said in a post on the association’s website that it could fragment care for children.

“It will likely cause children to forgo holistic well-child exams and comprehensive preventive care, early diagnosis, optimal therapy, and ensured timely vaccinations that are necessary to safeguard children’s health, especially during a pandemic,” Bailey said in the post.