Provider status, MTM expansion top APhA legislative initiatives

The American Pharmacists Association is advocating for provider status, better patient access to pharmacies, support for medication therapy management (MTM), and other initiatives at the congressional level this year.

Meanwhile, the association is advising federal officials about issues ranging from opioid abuse and Medicare payment policies to compounding regulations and drug importation.

Members of the APhA received an update about the association’s lobbying and advocacy efforts at its annual meeting in San Diego.

On the legislative lobbying front, the organization’s main goal is to convince members of Congress to support provider status. Under a proposal introduced this year in both houses of Congress, the Social Security Act would be revised to allow reimbursement of pharmacist services, under Medicare Part B, for patients in medically underserved areas.

The APhA is part of a coalition supporting provider status as a crucial tool to improve patient care and reduce health costs.

“By 2021, total healthcare spending is expected to reach $4.8 trillion,” said APhA’s senior lobbyist Michael Spira. In the United States, “nearly 70% are on at least one prescription drug, and more than 50% take two. Almost 50% of people prescribed medication for chronic conditions do not take them correctly.”

Will the legislation succeed?

Early signs are positive, Spira said, and support during the Senate budget process shows that “our message is resonating on the Hill and with the senators.”

The APhA is supporting other new legislation, including a Senate bill that would expand the reimbursement for MTM of chronically ill patients under Medicare Part D.

In terms of regulation, the APhA is focusing on changes to Medicare Part D. The process, however, is “not anywhere near as exciting as last year,” said Jillanne Schulte, JD, director of regulatory affairs for APhA.

Meanwhile, the association is working with federal officials to make sure that pharmacists aren’t stymied by rules requiring Medicare prescribers to be enrolled in the program. “Pharmacists weren’t intended to be included,” she said, and that could create problems in California, where provider status is in the works.  Federal officials are responding and looking into the issue, she said.

On the health policy front, the APhA is working on several issues, said Michael Ghobrial, PharmD, JD, APhA’s associate director of health policy for government affairs. The association is monitoring policy changes regarding biosimilar drugs, drug supply chain regulations, track and trace regulations, prescription drug abuse issues, and medical marijuana.

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