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Provider Status for Pharmacists: It's About Time

Pharmacy Times


Throughout the coronavirus disease 2019 (COVID-19) global pandemic, we have—rightly —seen an outpouring of support for frontline workers risking their lives for the benefit of others. Companies, schools, and community organizations have offered support through donations and free services. In New York and cities around the world, residents regularly cheered their health care heroes from their homes to thank them for their work addressing this crisis on the frontlines.


Pharmacists have been central health care heroes in the frontline fight against the spread of COVID-19. Throughout the pandemic, pharmacists have played a critical role in the COVID-19 response in several ways. These efforts include standing up mobile testing facilities, working alongside their colleagues to draft protocols and response plans, reinforcing messages about how to control the spread in their communities, providing curbside delivery, conducting virtual consultations, and compounding hand sanitizers.


Because they are trusted by patients, readily accessible in most American communities, and are highly skilled, pharmacists are vital to our COVID-19 recovery. However, unlike their acute and physician office counterparts, pharmacists’ legal capacity to assess, prescribe, and administer biological products varies from state to state.


For example, although pharmacists in all 50 states, Washington, DC, and Puerto Rico are permitted to administer vaccines, state laws limit the types of vaccines they can administer and restrict the types of patients they can serve. Furthermore, without provider status under Medicare Part B, pharmacies often experience hurdles obtaining reimbursement for emergency services provided during public health emergencies.


To effectively respond to COVID-19, our country is being asked to use all available health care resources to the fullest, which is why there has never been a better, or more important time, to grant provider status to pharmacists.


Fully leveraging pharmacists in COVID-19 response efforts

The Department of Health and Human Services (HHS) has recognized the important role that pharmacists will play in COVID-19 relief. On September 9, 2020, HHS issued guidance under the Public Readiness and Emergency Preparedness Act (PREP) authorizing state-licensed pharmacists to order and administer COVID-19 vaccinations to patients 3 years of age and older, preempting any state and local laws that prohibit ordering or administering vaccines.


In addition to vaccine administration, pharmacists can also help to relieve the strain on resources COVID-19 has caused if they are leveraged more fully. To preserve scarce hospital and acute setting resources, pharmacists should also have broad access to test for COVID-19, as well as flu, strep and minor ailments.


A list of joint COVID-19 recommendations by several major pharmacy organizations, including APhA, NCPA, ASHP, AACP and others goes even further, advising that pharmacists should also be allowed to order testing, conduct and interpret results, counsel patients and initiate treatment for infectious diseases where appropriate. During a time in which every provider is a vital resource, more patients receiving these services at the pharmacy frees up physician offices and hospitals for more urgent care. Additionally, integrating pharmacists into direct patient care has been shown to improve patient outcomes across health care settings and disease states.


Ensuring that patients can access testing, vaccines and necessary care will be critical to public health. Unfortunately, a physician shortage was already in place prior to the start of the pandemic, a situation that has only become exacerbated by providers becoming infected with COVID-19 and/or an increasing caseload.


According to the American Association of Medical Colleges 2019 report, there is currently a shortage of nearly 43,000 physicians. There is also a significant number of patients living in health care “deserts,” where access to care is limited.


The National Center for Biotechnology Information states approximately 20% of the US population, more than 50 million people, live in rural areas whereas only 9% of the nation’s primary care physicians practice in these communities. Pharmacists are uniquely positioned to help address this need. Ninety percent of Americans live within 5 miles of a pharmacy and, through the use of telepharmacy, pharmacists can deliver care remotely to medically underserved areas.


The urgent need for provider status

Although pharmacists are valued community health care providers and their ability to improve outcomes as part of a patient’s care team has been proven, as of October 2020, only 37 states allowed pharmacists to qualify as medical providers under the rules of Medicare Part B. Because of this, pharmacists face administrative barriers when seeking reimbursement for clinical services provided. Continue Reading