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Wild seeing so many HCWs who belong to orgs that have ACTIVELY LOBBIED AGAINST PHARMACIST PROVIDER STATUS making jokes about or inventing their own definitions of the word “provider”.
Here’s what it is and what it would mean for pharmacists and our patients...
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Here’s what it is and what it would mean for pharmacists and our patients...
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First, let’s get on the same page.
What’s a “provider”?
Defined in the Social Security Act
Able to bill Part B of the Medicare program
Includes individuals (NPs, PAs, dentists, PTs, MDs, DOs...) + health care facilities / orgs (hospitals, outpt surgery centers...)
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What’s a “provider”?
Defined in the Social Security ActAble to bill Part B of the Medicare program Includes individuals (NPs, PAs, dentists, PTs, MDs, DOs...) + health care facilities / orgs (hospitals, outpt surgery centers...)2/
Those individuals can bill Medicare for services that are allowed under their state scope of practice.
Pharmacists are NOT currently on the list.
Instead, pharmacists bill Part D or other pharmacy benefits for medications we dispense, not services we provide.
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Pharmacists are NOT currently on the list.
Instead, pharmacists bill Part D or other pharmacy benefits for medications we dispense, not services we provide.
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There *are* select populations eligible for medication management therapy (MTM) services through Part D, but this leaves out a significant proportion of patients and does not nearly encompass all the amazing clinical services pharmacists are trained to provide to patients.
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Worthy of a whole separate , but clinical pharmacy services are great for patients!
Various services improve outcomes, improve patient understanding of medications, reduce med errors, reduce cost (/treatment burden), or improve access to certain meds (OCPs, PrEP, etc.)
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, but clinical pharmacy services are great for patients!Various services improve outcomes, improve patient understanding of medications, reduce med errors, reduce cost (/treatment burden), or improve access to certain meds (OCPs, PrEP, etc.)
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When you or the orgs you donate money to lobby AGAINST pharmacist provider status, you’re saying that you don’t think pharmacists should be reimbursed for the work we do with our brains, that we are only there to put pills in a bottle.
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Not letting pharmacists bill for services hurts independent pharmacies and local stores who end up doing this work without reimbursement because their patients need it, while mail order programs owned by large chains get to focus on dispensing metrics tied to revenue.
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This not sustainable.
Pharmacy deserts continue grow and patients have a harder time accessing both the expertise of a pharmacist and their prescriptions.
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Pharmacy deserts continue grow and patients have a harder time accessing both the expertise of a pharmacist and their prescriptions.
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For another pharmacist perspective on this topic, check out this article from the @grassrootsrph: https://grassrootsrph.com/2020/06/29/provider-status-explained-why-do-pharmacists-need-provider-status/
-ing some experts on this topic, 
!
