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Provider Status Initiative Takes Center Stage at HOPA

TOP - May 2017, Vol 10, No 2 - HOPA
Chase Doyle

Anaheim, CA—As pharmacists’ responsibilities extend beyond dispensing medications to include advanced patient-centered services, many already meet the definition of nonphysician provider under Medicare Part B, yet they are often not reimbursed for their services.

At the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference, a trio of HOPA representatives joined Walgreens’ Head of Federal Advocacy in a panel discussion covering the latest legislative efforts to achieve provider status, which would enable pharmacists to play an expanded role in disease management while receiving reimbursement under Medicare Part B.

In 2015, the Patient Access to Pharmacists’ Care Coalition introduced a bill called the Pharmacy and Medically Underserved Areas Enhancement Act, which will amend the Social Security Act to include pharmacists on the list of recognized healthcare providers. HOPA has taken this initiative on as one of its own health policy issues and advocates on behalf of this bill on designated Capitol Hill Days, said Jerrica Mathis, MSEd, Senior Government Relations Manager for HOPA.

“There are still state regulations and guidelines that would have to be followed, but this bill would allow pharmacists in federally designated underserved communities to deliver care to patients and be reimbursed for their services,” said Ms Mathis.

Alethia Jackson, Esq, Head of Federal Advocacy at Walgreens, shared the origins of the legislation.

“In 2014, various pharmacy groups were pushing for provider status in Washington, and every push was a little different. We realized that we needed a unified voice in pharmacy to advocate for provider status in a very general way under Medicare Part B and bring pharmacists on par with other nonphysician practitioners. We needed to have all pharmacists singing from 1 hymnal and have as broad support as possible,” Ms Jackson explained.

According to Ms Jackson, it was also important for the legislation to be bipartisan—to make sure that Democrats, Republicans, and members of Congress, who represent rural and urban areas, supported the bill.

“People cannot agree about anything concerning healthcare these days, but we were able to get 286 cosponsors in the House and 60 in the Senate—across the partisan divide. We’d like to get back to that number again,” said Ms Jackson.

The bill was reintroduced in January 2017 and started the session with 33 cosponsors in the Senate from 24 states. There are currently 146 cosponsors in the House, with 33 states represented.

“We hope to reach the 286 cosponsors that we had last session. So far, everyone has really rallied around this issue,” said Ms Jackson.

As the coalition continues to garner support in Washington, members of HOPA are also doing their part to engage elected officials.

Michael Vozniak, PharmD, BCOP, Health Policy Committee Chair for HOPA, highlighted the importance of annual Capitol Hill Days in pushing the initiative.

“Last year our primary focus was on provider status. Our Board of Directors traveled to Washington with HOPA’s Health Policy Committee and lobbied. We are scheduled to have another [Capitol] Hill Day in the middle of May, and provider status will be a big focus again,” said Dr Vozniak.

As Dr Vozniak reported, the Patient Access to Pharmacists’ Care Coalition has put together a comprehensive target list that includes Congressional Committees of Jurisdiction (House and Senate), Committee on Energy and Commerce (House), Committee on Ways and Means (House), and the Committee on Finance (Senate). Engaging members of Congress is the number-1 priority of HOPA’s health policy activity, said Dr Vozniak.

In addition, HOPA is encouraging its members to reach out to patient advocacy groups so that the voice of those who benefit from pharmacists’ services can be heard.

“Those consumers are the loudest voice on Capitol Hill right now. Patient advocacy groups are already anxious and wanting to move forward, especially those representing underserved communities that desperately need access to these services,” said Dr Vozniak.

Ms Jackson also underscored the importance of framing provider status within the current narrative of access to care.

“We want to make sure that people don’t lose access to care. As Congress looks for additional ideas to include in a replacement package, provider status needs to be brought forward as a potential solution,” said Ms Jackson.

For oncology pharmacists looking to help the cause, however, hosting a site visit for a member of Congress may be the most effective strategy.

“I can’t emphasize enough how important site visits are, especially for oncology pharmacists. Most people are unaware of the extent of the training. It’s a great way to make ‘true believers’ out of elected officials, and it’s a terrific educational tool,” said Ms Jackson.

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Last modified: May 10, 2017