Provider Status Legislation

Legislation was once again introduced in 2015 in the U.S. House and Senate to recognize pharmacists as providers under Medicare Part B.

The companion bills, S. 314, introduced by Sens. Chuck Grassley (R-IA), Sherrod Brown (D-OH), Robert Casey (D-PA), and Mark Kirk (R-IL), and H.R. 592, introduced by Reps. Brett Guthrie (R-KY), G.K. Butterfield (D-NC), Todd Young (R-IN), and Ron Kind (D-WI), will enable patient access to, and reimbursement for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. Pharmacists, as the most accessible health care professionals, are uniquely positioned to provide patients in medically underserved communities, access to health care services that are already within their scope of practice. By providing for a payment mechanism under Medicare Part B, the bill will allow pharmacists to help fill the gaps in care that have been created by shortages of health care professionals and increases in the number of Americans who are now eligible to gain health insurance under the Patient Protection and Affordable Care Act.

Provider status continues to be a profession-wide goal. Activity really took a jump with the formation of the Patient Access to Pharmacists’ Care Coalition (PAPCC). The coalition currently represents many organizations and continues to grow. Members include organizations representing patients, pharmacists, pharmacies, and other interested stakeholders.

This current legislation would enable patient access to, and payment for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. Their primary goal is to expand medically underserved patients’ access to pharmacist services consistent with state scope of practice law.

The passage of HR 592 and S. 314 may be a long term effort that will require some solid grassroots advocacy from all pharmacists. South Dakota's entire South Dakota Congressional Delegation is on board as co-sponsors! We’ll continue to work with our national partners to make sure that you are kept up to date on the progress of these important bills and PAPCC.