Provider status bills introduced in Massachusetts

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State-level provider status has direct implications for pharmacists practicing in Massachusetts, contributes to the national effort

 

Like California, Massachusetts has introduced new legislation to recognize pharmacists as providers. Two bills, HB 2060 and SB 484, both titled An Act Recognizing Pharmacists as Healthcare Providers, are now working their way through the 2-year legislative session that began on January 1, said David Johnson, Executive Vice President of the Massachusetts Pharmacists Association (MPhA).

HB 2060 simply would include pharmacists in the definition of a health care provider, but wouldn’t require any public or private payer to compensate pharmacists, according to Johnson. SB 484 also would add pharmacists to the definition of a health care provider but would require any blanket insurance plan to provide benefits for services of a registered pharmacist acting under the authority of a collaborative practice agreement; this bill was filed through the efforts of MPhA in the previous legislative session.

HB 2060 was introduced by Massachusetts state Rep. Angelo J. Puppolo Jr., JD (D-Springfield). SB 484 was introduced by Massachusetts state Sen. Michael J. Rodrigues (D-Westport).

“Fighting for provider status in Massachusetts is also a way of contributing to the effort to recognize pharmacists as providers under the federal Social Security Act,” Johnson said. “As the ‘laboratories of democracy,’ states that have gained provider status and are climbing the mountain to secure compensation for services as providers will help convince officials at the federal level to yield to the inevitable.”

Importance of provider status

State-level provider status has direct implications for pharmacists practicing in Massachusetts, Johnson said. First, pharmacists writing prescriptions under collaborative practice agreements have had their prescriptions rejected at pharmacies by certain payers who point to provider status as a requirement for issuing a valid prescription.

Second, and most important, Johnson continued, Massachusetts passed the final phase of its health care reform experiment last year. Focused on payment reform and cost containment, this “massive act” will create a “bureaucratic infrastructure” to certify the composition of care teams such as accountable care organizations and medical homes, and to approve innovative services to patients with chronic diseases. Under this law, these services—several of which could best be provided by a pharmacist—must be provided by a health care provider as defined by the state.

Background on state efforts

Last summer, MPhA hosted a legislative summit where state schools of pharmacy and sister state pharmacist associations met; provider status for pharmacists emerged as the consensus legislative priority.

A hearing has not yet been scheduled for SB 484. HB 2060 received its hearing before the state legislature’s Public Health Committee on April 2—the same hearing that was “dominated by the oversight bills filed in response to the New England Compounding Center tragedy,” Johnson said. At the hearing, “the pharmacists who testified clearly made a positive impression. Each had impressive outcome data and made a compelling case that services such as theirs—provided either by grants or through pharmacy school subsidies—would be expanded if provider status were passed into law.”

In addition, continued Johnson, “we enlisted a physician who spoke eloquently about the contributions of the pharmacist at her health center who met with her chronic disease patients directly, and greatly improved their health by managing their medication therapy.” Several other physicians and at least one health care administrator provided written testimony in favor of the bill. No oral testimony in opposition to the bill was offered, Johnson said—and to date, no written testimony in opposition has been received by the committee.

“With the [Public Health] Committee’s efforts focused almost exclusively on compounding oversight, provider status may have to wait until work on that bill is concluded,” Johnson said. In the meantime, MPhA continues to meet with state legislators.

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