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Update: Bipartisan House bill seeks to designate pharmacists as healthcare providers in Medicare


ARLINGTON, Va. — Bipartisan legislation that would designate pharmacists as healthcare providers under the Medicare program was introduced in the U.S. House of Representatives on Tuesday. The bill would amend The Social Security Act of 1935 to enable pharmacists to work to their full capability by providing underserved patients in the Medicare program with services not currently available to them.

The legislation has earned the support of several industry groups including the National Association of Chain Drug Stores, the National Community Pharmacists Association and and the Patient Access to Pharmacists' Care Coalition.


H.R. 4190, introduced by Reps. Brett Guthrie, R-Ky., G.K. Butterfield, D-N.C., and Todd Young, R-Ind., would elevate pharmacists’ ability to help patients achieve success in their healthcare. Specifically, Medicare patients could have enhanced access to pharmacy services including immunizations, diabetes screenings and self-management education, cardiovascular screenings and behavioral therapy within the scope of state laws under this new bill.

“The provider status designation will amplify pharmacists’ ability to do what they do best – serve patients and help them on the road to better health,” stated NACDS president and CEO Steve Anderson.

“We applaud the leadership of Reps. Guthrie, Butterfield and Young in introducing this bipartisan, commonsense legislation,” added Anderson.  “As one of the most trusted healthcare professionals, pharmacists are extremely valued by patients in the greatest of need. From helping patients take their medications effectively and safely, to providing preventive services, pharmacy services help keep people healthier and reduce costs.”

Responding to the news, NCPA CEO B. Douglas Hoey stated, “Independent community pharmacies often care for underserved patients in rural and urban areas alike. Most of these providers are located in smaller communities and approximately 1,800 independents are the only pharmacy option in their rural communities. In other areas, independent pharmacies cater to diverse populations for whom English may be a second language. In these scenarios and others, independent community pharmacists are ideally positioned to play a greater role in health care, so NCPA is proud to support this legislation.”

Also applauding the introduction of the legislation, Vince Ventimiglia, a principal with FaegreBD Consulting and advisor to the PAPCC, stated, "The PAPCC is encouraged by this significant step forward to increasing patient access to health care in a cost-effective manner by making pharmacists, as key members of the patient care team, eligible for payment under Medicare Part B, and we look forward to working with our champions and others in Congress to enact this common-sense legislation into law.”

The U.S. healthcare system is on a transformational path and, in recent years, pharmacists have played an increasingly important role in the delivery of healthcare services. Pharmacists now commonly provide immunizations and medication therapy management services. They are also developing new approaches through medication synchronization programs, identifying and treating medication adherence issues, and working to have the ability to provide simple medical testing services.

However, the lack of pharmacist recognition as a provider by third party payors — including Medicare and Medicaid — has limited the number and types of services pharmacists can provide, even though fully qualified to do so, NACDS stated.

“Retail pharmacies are oftentimes the most readily accessible healthcare provider. Research has shown that nearly all Americans (89%) live within five miles of a community retail pharmacy,” added Anderson. “Combined with their expertise and training, pharmacists as healthcare providers can serve their patients to their full capabilities.

“Expanding the role of pharmacists to meet the demands of more than 30 million newly uninsured patients can only help alleviate the increased need for healthcare services.  And we are hopeful that this legislation is the first step towards the ultimate goal of achieving success for patient health.”


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