APhA2017: Provider status opportunities at federal, state levels

Sessions include Provider Status: It’s Happening, Your Annual Legislative and Regulatory Update

At the 2017 APhA Annual Meeting & Exposition, a packed session on Friday on Provider Status: It’s Happening focused in large part on the opportunities that exist on the state level to achieve recognition and payment for patient care services pharmacists provide. Another packed session on Saturday from APhA Government Affairs staff provided attendees with an update on efforts at the federal level to increase access to pharmacists’ services during the Your Annual Legislative and Regulatory Update.

At the provider status session, speakers noted that the current landscape to expand pharmacists’ role in patient care—provider status—is favorable, with advancements being made each year in states, and highlighted the recent success in Washington.

Jeffrey Rochon, PharmD, CEO of the Washington State Pharmacy Association, gave a detailed account of the way pharmacists in Washington got SB 5557 passed in early 2015—a bill requiring commercial or private health care plans regulated by Washington State to enroll pharmacists into their provider networks, and it mandates that these plans pay pharmacists for services provided if they are within a pharmacist’s scope of practice.

With more than 10,000 active collaborative practice agreements in existence for pharmacists in Washington State, Rochon said they wanted to “push the bar” even further and make sure pharmacists were compensated for their services. The process was long and involved and passage of the bill was achieved largely through several partnerships with stakeholders ranging from legislators to patient advocacy groups. Part of the process also involved legal maneuvering with an existing Washington State law having to do with providers and health care plans.

APhA Senior Vice President of Pharmacy Practice and Government Affairs Stacie Maass, BSPharm, JD, also spoke about federal provider status legislation, the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 109), which was reintroduced to Congress in January and now has 146 cosponsors in the House and 33 in the Senate. Maass discussed the general health care environment paving the way to pharmacist-provided care, especially the need for increased patient access to health care, and emphasized that there are many pathways to provider status, including value-based payment and delivery, medical homes, and private payers.

At the legislative and regulatory update, APhA Senior Lobbyist Alicia Kerry Mica discussed recent activity by APhA and the Patient Access to Pharmacists’ Care Coalition (PAPCC) in support of federal provider status efforts—the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 109).

She noted APhA is a founding member of the PAPCC and described the coalition’s strategy and next steps—including continuing to build cosponsor support and utilizing the full coalition grassroots abilities.  She also highlighted APhA resources available at PharmacistsProvideCare.com and encouraged pharmacists to  share their patient care stories with policy makers.

Mica described growing support for pharmacists’ value from CMS, the National Governors’ Association, journals, and the media. She mentioned a statement from U.S. Health & Human Services Secretary Tom Price, MD, during his confirmation proceedings that he is open to all options to address the impact of the ongoing physician shortage in rural areas and that paying pharmacists in underserved areas to engage in certain medical services could work well. 

Attendees at Your Annual Legislative and Regulatory Update also received a whirlwind, detailed tour of past and upcoming pharmacist and pharmacy issues, focused primarily at the federal level. On the regulatory side—delivered by APhA Director of Regulatory Affairs Michael Baxter and APhA Associate Director of Health Policy Jenna Ventresca, JD—key topics included the Medicare Access and CHIP Reauthorization Act (MACRA), compounding, track and trace, biosimilars, and opioids.

In addition, three APhA awards were presented at the APhA Political Leadership Reception: Pharmacists Driving Political Change on Friday. The Hubert H. Humphrey Award went to Iowa state Rep. John Forbes (D-40), BSPharm. The recipient of the Good Government Pharmacist-of-the-Year Award was Michael Blaire, BSPharm. And the Good Government Student Pharmacist-of-the-Year Award went to Marilyn Gaske of the University of Illinois at Chicago College of Pharmacy.