The only primary care provider who isn’t officially a provider
Friday, May 16, 2014
What would you think if the federal government told you that professional baseball players were not athletes even though they make their living performing athletic feats? What if the federal government told you that plumbers were not plumbers even though they make their living fixing your plumbing?
What if the federal government told you that pharmacists were not healthcare providers even though they have been providing healthcare since the birth of our nation?
Curiously enough, Section 1861 of the Social Security Act recognizes audiologists, certified nurse midwives, certified registered nurse practitioners, certified registered nurse anesthetists, physician assistants, licensed clinical psychologists, licensed clinical social workers, physical and occupational therapists, and registered dietitians as providers but fails to recognize pharmacists.
This oversight means that pharmacists cannot directly bill Medicare for their services at the same moment in time when the Affordable Care Act virtually mandates that all enrollees undergo comprehensive medication therapy management.
Current doctor of pharmacy students spend in excess of 128 credit hours of graduate education learning how to practice medication management. No other healthcare provider — with the possible exception of physicians — has anywhere near half that training.
I'm not quite sure who the government thinks is going to provide these medication management services, but on the surface this oversight seems hard to explain.
On the one hand, Medicare is saying that medication therapy management is a valuable service that saves the healthcare system resources and improves outcomes for patients. On the other hand, the government refuses to recognize that the most highly-trained professional medication expert in the healthcare system is not allowed to provide these services.
The National Association of Boards of Pharmacy website refers to pharmacists as essential healthcare providers. But the federal government is not even consistent within its own ranks.
The United States Public Health Service states that the daily responsibilities of pharmacy officers may include: delivering direct patient care services in advanced practice settings. United States Department of Veteran Affairs describes their pharmacist job opportunity by saying that: many of our pharmacists obtain prescriptive authority within their defined scope of practice, and function as providers responsible for direct patient care.
Admittedly the process of making legislation sometimes leads to strange interpretations of reality. In this case, what would you think if the federal government decided that you could not take advantage of your favorite pharmacist's service at the same time they were taking full advantage of pharmaceutical care for their federal employees?
Isn't it time for some common-sense consistency and fairness in the way these rules are applied?
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