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Pharmacist-Provided Care: It’s All About Our Patients!

Executive Update

Happy Friday! The future is bright, my fellow pharmacists and pharmacy professionals! On March 31, 2017, Governor Bill Haslam signed House Bill 405 and Senate Bill 461 into law. With the passage of this law – the 2017 Tennessee “Pharmacists as Providers” Law – Tennessee state legislators and Governor Haslam have shown support for our patients and affirmed the role of pharmacists as members on the health care team in Tennessee. As one of TPA’s top legislative priorities for 2017, TPA is proud to have worked with lawmakers to pass this important law on behalf of our members, our pharmacy profession, and most importantly, our patients.

Micah CostEffective July 1, 2017, pharmacists will be authorized to participate in, receive referrals, and be reimbursed as providers within managed health insurance issuers’ medical provider networks. This legislation paves the way for our patients to gain access to care provided by Tennessee pharmacists acting within the scope of their license or certification. Prior to the passage of this law, pharmacists have been notably absent from many of Tennessee’s managed health insurance issuers’ medical provider networks and have not been recognized as members of larger health care teams.

TPA greatly appreciates Senator Mike Bell and Representative Bryan Terry for introducing this legislation, as well as co-sponsors Senator Ferrell Haile, Senator Rusty Crowe, Senator Doug Overbey, Representative Cameron Sexton, Representative Art Swann, Representative Bill Dunn, and Representative David Byrd, for their support. TPA is also grateful for the unanimous support of the Tennessee General Assembly and Governor Haslam in enacting this law. Finally, TPA would like to recognize and thank every one of our valuable TPA members who advocated for this legislation and actively contributed to the passage of this law! Without your support and participation, this legislative victory would not have been possible!

2017 Tennessee “Pharmacists as Providers” Law:

  • Establishes a pathway for pharmacists, acting within the scope of their license or certification under state law, to be credentialed with managed health insurance issuers.
  • Supports the inclusion of pharmacists as members of the larger health care team, which will enhance communication, collaboration, and patient referrals to physicians and other health care providers.
  • Authorizes enrolled and credentialed pharmacists to participate in, receive referrals, and be reimbursed for covered services or indemnification.
  • Requires that managed health insurance issuers include pharmacists as providers to the extent necessary to meet the needs of the managed health insurance issuer’s plan and its enrollees.

Why should pharmacists be recognized as providers? We all know the answers, but sometimes it’s important to remind ourselves and others. Pharmacists are highly trained, well-qualified, and aligned to provide care and meet the needs of our patients and our communities. According to the Tennessee Department of Health, 94 of 95 counties in Tennessee are designated as either partially or fully medically underserved areas, meaning patients in these areas do not have access to providers and essential health services. Pharmacists, as the medication experts, are ready to help! We all know that a strong relationship between patients and/or their caregivers and their personal pharmacists, working with the health care team, results in better health outcomes, decreased costs, and a more coordinated and collaborative approach to team-based health care. Often, pharmacist-provided patient care results in the identification and referral of patients to primary care physicians and other health care providers for follow-up evaluation, management, and treatment. Finally, the Tennessee Board of Pharmacy has implemented rules (1140-03-.17), which establish the pathway through which state-licensed prescribers and pharmacists may enter into collaborative pharmacy practice agreements to provide patient care. Through collaborative pharmacy practice, this team-based approach to care involving physicians and prescribers will be essential to helping our patients reach their optimal health outcomes.

However, the real work is just getting started. Over the next few months, TPA will be working with managed health insurance issuers to implement this new state law and establish credentialing and enrollment processes for pharmacists to become providers within their medical provider networks. In addition, we all need to take advantage of the April recess period and engage our US Congressional Representatives and US Senators to ask for their support for the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592 and S. 109). If you cannot meet with them or host them at your pharmacy practice site, I would encourage you to send communications to your US Representative and US Senators about this important legislation using the T-PLAN automated email link. TPA has written the message (which you may edit), and T-PLAN will identify your legislators and their email addresses, so sending an email will only take you a few moments to complete!

Thanks for everything you do daily to help your patients achieve optimal health outcomes! I am blessed to have the opportunity to serve each of our members, and I am honored and proud to be one of your professional colleagues!

Micah Cost, PharmD, MS
TPA Executive Director