Legislation Benefits Patients in Medically Underserved Communities

The pharmacy community is applauding the reintroduction of the Pharmacy and Medically Underserved Enhancement Act (S. 109 and H.R. 592). The legislation will amend the Social Security Act to recognize pharmacists as providers under Medicare Part B.

This change will help address gaps in the nation’s health-care system by increasing access to pharmacists’ services for patients who live in medically underserved communities, according to a statement from ASHP.  

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Co-sponsors of the bill in the House of Representatives are Reps. G.K. Butterfield (D-NC), Tom Reed (R-NY), and Ron Kind (D-WI). Senators Sherrod Brown (D-OH) and Robert Casey (D-P) are the cosponsors of S. 109.

“H.R. 592 [along with S. 109], will enable Medicare patients in medically underserved communities to have better access to important health-care services that are often inaccessible to many Medicare beneficiaries, including health and wellness and chronic disease management. This legislation increases access by enabling pharmacists to provide services they are authorized to provide under state law, and are prepared to provide through their extensive profession education,” said a

Paul W. Abramowitzspokesperson for the Patient Access to Pharmacists’ Care Coalition (PAPCC) in a written statement.

“We commend the bill’s sponsors for their continued leadership on this important patient care and access to care issue,” said ASHP CEO Paul W. Abramowitz, PharmD, FASHP. “Patients all across the country will benefit from the vital clinical services pharmacists provide to improve medication therapy outcomes, and overall public health. We look forward to working with Congress to enact this critical legislation,” Abramowitz said.

Related article: Provider status

“Both H.R. 592 and S. 109 would change Part B of the Medicare program to recognize pharmacists as providers, said Christopher J. Topoleski, Director, Federal Legislative Affairs, Government Relations Division, ASHP. This would apply to any Part B setting, including an ambulatory care clinic, but not an inpatient hospital, which falls under Medicare Part A. If a pharmacist is working in a hospital outpatient center, then this would be [covered] under Medicare Part B.”

Topoleski explained that the bills allow pharmacists to provide all the services allowed under their state’s practice act. “The bills will allow for the same services to be performed for Medicare beneficiaries as are allowed for non-Medicare patients, subject to a pharmacist’s state scope of practice,” he said. The details of how pharmacists would bill [for these services] would be generated by the Centers for Medicare and Medicaid Services,” Topoleski told Drug Topics.

Christopher J. Topoleski

“As a lead member of PAPCC, ASHP will be working diligently to help facilitate passage of the legislation, most likely as part of a larger Medicare package, later this year. In fact, early discussions between PAPCC and key congressional staff are already occurring, as we seek to position the legislation to be part of a larger Medicare bill,” said Topoleski.

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On the chain side, CVS Healthcare discussed the importance of the impending legislation. A spokesperson for that pharmacy chain told Drug Topics, “Pharmacists are on the front lines of health care in communities across America, and in rural and underserved areas the access to health care they provide is even more important. Pharmacists can help patients manage chronic conditions and improve medication adherence, leading to better patient outcomes and greater focus on prevention and wellness. Increasing access to pharmacists in medically underserved communities will contribute to improved health outcomes and lower costs for patients in Medicare,” said the spokesperson.

But Topoleski warns that there is still work to be done. “While a number of states have enacted changes to their individual practice acts that achieve provider status at the state level, there is still no federal recognition of pharmacists as providers under the Medicare program. As such, they are not able to fully participate in innovative team-based models such as accountable care organizations (ACOs). A change at the federal level is still required for their full participation in Medicare Part B,” Topoleski said.