McKnight's Long-Term Care News, October 2018, Feature 2, Medication Management

Pharmacists are lobbying for Medicare Part B provider status during the pandemic, pushing to insert a policy in the upcoming coronavirus relief bill that would expand their role in COVID-19 testing and vaccinations.

The first version of the Health, Economic Assistance, Liability Protection and Schools Act, unveiled last week, does not include this designation for pharmacists, but advocates say they will continue to push their cause as the bill is fine-tuned. The ability of pharmacists to directly provide and bill for testing and related services would not only help expand testing access overall, but could be helpful to certain eldercare providers, particularly in senior living communities, said Ronna Hauser, PharmD, vice president of policy and government affairs operations at the National Community Pharmacists Association. 

“We’re fighting for pharmacists to deal with Medicare directly, not only for the tests, but for the associated services, as well as vaccines,” she said. “That would be an opportunity for pharmacists and their patients across different settings.” Senior living operators have not been tagged to receive the testing equipment promised to nursing homes by federal health agencies, and these operators may benefit from a COVID-19 testing partnership with pharmacists, she added.

“There are a lot of assisted living and other types of facilities that our members serve who would not be receiving [federal testing equipment]. So there could be a big role to play for pharmacies in assisting the [communities] that they service.”

The Centers for Medicare & Medicaid Services has recognized pharmacists as essential care providers during the pandemic. In May, they were temporarily authorized to bill Medicare for running COVID-19 tests. But provider scope of practice for these services varies widely by state and interferes with implementation, said Sandra Leal, PharmD, MPH, president elect of the American Pharmacists Association, in an interview with the Journal of Clinical Pathways. There is a need to “lessen the gap between individual states’ scope of practice language versus what is being allowed at the federal level,” she said. 

Another key factor keeping pharmacists from assuming a bigger role as pandemic providers is difficulty procuring the tests, the NCPA reports.

“A lot of our pharmacies cannot access the tests, either because the tests they would be allowed to administer are being prioritized to other healthcare settings, or the federal government has secured many of those tests through public-private partnerships,” Hauser said. In addition, the tests that are available have not been weighed for point-of-care use in the pharmacy setting, she added.

Meanwhile, pharmacists foresee an opportunity to be a major player in increasing access to COVID-19 vaccinations, said Bill Popomaronis, RPh, NCPA vice president of professional affairs.

“We anticipate a big boom over the next year as the coronavirus vaccine becomes available, complementing that with pneumococcal, influenza and shingles vaccines,” he said. Pharmacists are in the right position not only to administer vaccinations, but to ease operational barriers such as drug shortages among patient groups, he added.

The APhA is encouraging pharmacists to lobby state officials to include language in scope-of-practice descriptions that “allows for the timely inclusion of vaccines as they become available,” Leal said.