States Expand Pharmacist Provider Status CMM

ASHP’s advocacy is off to a strong start in 2023. Several states have expanded reimbursement for pharmacist services this year.

Provider Status

On Feb. 27, Wyoming S.F. 0009 was signed into law. WY S.F. 0009 authorizes reimbursement for services provided by pharmacists under Medicaid within their scope of practice, effective July 1. Similarly, Virginia S.B. 1538 was passed by the Virginia legislature earlier this year and signed into law on March 23. VA S.B. 1538 requires Virginia Medicaid to reimburse pharmacists for any covered service provided under a collaborative agreement or statewide protocol.

On March 29, the Maryland General Assembly passed S.B. 678 – Reimbursement for Services Rendered by a Pharmacist. S.B. 678 requires both Medicaid and state-regulated commercial insurance plans to recognize pharmacists as providers and reimburse for all covered services within their scope of practice, effective January 1, 2024. The bill will now proceed to the governor, who is expected to sign it into law.

Effective April 1, MO HealthNet, Missouri’s Medicaid program, permits pharmacists to receive reimbursement for any covered service that falls within their scope of practice. Pharmacist providers will use the same billing codes, and receive the same reimbursement, as other practitioners. Read the full announcement from MO HealthNet here.

Comprehensive Medication Management

Finally, this week, North Dakota passed H.B. 1095, which requires coverage for licensed pharmacists to provide comprehensive medication management (CMM) services. ASHP worked with the Get the Medications Right Institute (GTMRx) and the North Dakota Society of Health-System Pharmacists to testify in support of the legislation, which would ensure patients have access to critical CMM. 

ASHP congratulates the Wyoming Society of Health-System Pharmacy, Virginia Society of Health-System Pharmacists, Maryland Society of Health-System Pharmacy, Missouri Society of Health-System Pharmacists, and North Dakota Society of Health-System Pharmacists on their successful advocacy on behalf of the pharmacy profession. ASHP will continue to update members on nationwide provider status advocacy efforts.