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Provider status for pharmacists becoming a reality in many states
Michelle Powell 2989

Provider status for pharmacists becoming a reality in many states

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Today's Perspective

Kristin Wiisanen, PharmD, FAPhA, FCCP

For the past 5 years, my clinical team and I have put extensive time and effort into obtaining payment for pharmacists’ time for outpatient clinical pharmacogenomics visits. We conducted a successful pilot with the self-insured group within our health system, implemented a model in which pharmacists’ time contributed to increased relative value unit-based physician compensation, utilized telehealth to reduce cost and overhead of the service, and initiated many other strategies. I would love to say these efforts have paved a path to compensation. Unfortunately, they have not. A little over a year ago, we transitioned to a patient self-pay model that has been successful. But in this and many other areas, pharmacists are limited in the patient care they can provide without having provider status.

Fortunately, this is changing. This month’s Pharmacy Today cover story reviews the national landscape and progress in obtaining provider status and bringing pharmacists beyond the counter. From North Dakota’s HB 1095 that allows for reimbursement of comprehensive medication management provided by pharmacists by health plans in the state to Virginia’s SB 1538 that recognizes pharmacists as providers within the state Medicaid program and requires Medicaid to cover pharmacists’ patient care services, things are looking up for pharmacists and their patients. Check out the cover story to see a full listing of state-by-state provider status changes.

In this issue, you’ll also find the latest on newly approved drugs, including fezolinetant, a new nonhormonal therapy for hot flashes, and get an update on topical antibiotics and antiseptics. Find out what you need to know about the new respiratory syncytial virus vaccines, learn what’s behind the surge in pediatric melatonin overdoses, and catch up on your CPE credit with this month’s article on new therapeutic agents marketed in 2022.

In many ways, measures put in place to address immunization, testing, and treatment needs of the COVID-19 pandemic opened doors for expanding pharmacists’ scope of practice. These strategies also changed patients’ expectations about the value of care that their pharmacist could provide. It is welcome news that legal and regulatory steps are now being considered and passed in many states making many of these and other changes permanent for pharmacists and their patients. ■



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