Pharmacist Provider Status Bill Reintroduced

A bipartisan group of legislators in the House of Representatives reintroduced a bill to allow Medicare to cover state authorized pharmacist services. The bill, known as the Pharmacy in Medically Underserved Areas Enhancement Act, makes the same changes to the Social Security Act proposed by HR 4190, first introduced last year. The text of the new bill, known as HR 592, is publicly available online.

Representatives Brett Guthrie of Kentucky, G.K. Butterfield of North Carolina, Ron Kind of Wisconsin, and Todd C. Young of Indiana jointly announced they introduced the bill to remedy this situation and allow for pharmacists to be reimbursed through the Medicare program for providing services that many states already allow.

Last year’s HR 4190 did not make any progress in either of the committees to which it was referred, but the legislation was able to get 123 cosponsors before it expired at the end of the congressional session. 83% of the cosponsors returned to Congress earlier in January.

The reintroduction of the bill is different this time as another original sponsor, Kind, was added. This time around, there is also an agreement with the Senate to introduce a companion bill. The patient access to pharmacist care coalition is responsible at least in part for both of these developments.

The bill would allow pharmacists to be recognized as non-physician providers under Medicare, therefore bringing new value to healthcare consumers. Pharmacists are incredibly limited in what they can do because of state and federal level regulations. The growing population is one of the reasons why pharmacy providers need to be better utilized.

Medically underserved areas may either be rural with low population, or be urban and have too few healthcare providers to properly care for the dense residential population. A significant portion of the country falls under either of these definitions, and as our population continues to grow, so will the underserved portions of the country.

An issue that legislators face is the matter of whether patients that are coming to see the pharmacist live in a medically underserved area, or are automatically considered part of a medically underserved area where pharmacists are practicing. What’s important is not where the pharmacists practice, but where the patients they serve live. If the bill becomes law, regulations developed by the centers for Medicare and Medicaid services will define the settings under which it will apply.