The Pharmacy and Medically Underserved Areas Enhancement Act (S. 314/H.R. 592)

Talking Points

Abbreviated Talking Points

  • House & Senate Background
  • Tens of millions of Americans, including millions of Medicare beneficiaries, live in medically underserved communities.
  • The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592) seeks to improve the health care access to these Medicare patients by allowing certain Medicare Part B services to be delivered by state-licensed pharmacists in these communities.
  • The bill would make available certain health care services that pharmacists are allowed to perform according to each state’s laws-it does not expand pharmacists’ scope of practice.
  • Pharmacists, due to their accessibility and advanced clinical education with a specific emphasis on medications, are uniquely positioned to deliver many needed health care services such as:
  • Chronic disease management and counseling;
  • Health and wellness tests;
  • Immunizations; and
  • Care transition services.
  • House “Ask:”House Champions and interested stakeholders are committed to advancing this legislation through “regular order.” We strongly support and encourage the Energy and Commerce Committee to hold a hearing including discussion of H.R. 592 in September.
  • Senate “Ask:”Please support S. 314 - an important step in helping Medicare beneficiaries access many of the health care services they need.

Broad Talking Points

The “Ask”

  • Congress should pass the Pharmacy and Medically Underserved Areas Enhancement Act(S. 314/H.R. 592).

What would the legislation do?

  • The bill would allow certain Part B services to be delivered by state-licensed pharmacists in Medically Underserved Communities.
  • The bill does not expand pharmacists’ scope of practice; rather, it improves healthcare access by making available to these Medicare patients services that pharmacists are allowed to perform according to each state’s laws.
  • For many states, the improvement of access would include:
  • Chronic disease management and counseling;
  • Health and wellness tests;
  • Immunizations; and
  • Care transition services.

Why is the legislation needed?

  • Tens of millions of Americans, including millions of Medicare beneficiaries, live in Medically Underserved Areas or Health Professional Shortage Areas or are members of a Medically Underserved Population.[1]At-risk Medicare beneficiaries in these “Medically Underserved Communities” have limited access to these services.
  • The legislation is an important step in helping Medicare beneficiaries access many of the health care services they need.
  • This legislation is consistent with the move toward value-based care,as allowing pharmacists to provide Medicare Part B services will further facilitate and supportthe integration of pharmacists into the patient’s healthcare team while providing much needed access points for at-risk beneficiaries.

Why pharmacists? Are they trained and ready to provide these services?

  • Pharmacists, due to their accessibility and advanced clinical education with a specific emphasis onmedications,are uniquely positioned to deliver many needed healthcare services in Medically Underserved Communities.
  • Approximately 67,000 pharmacies operate in the United States today, and 86 percent of the population lives within fivemiles of a pharmacy.
  • According to the National Governors Association, “Pharmacists have the professional expertise to address key challenges facing the health care system, including the prevalence of people who have multiple chronic conditions and the increased use of more complex medications to manage those diseases.”[2]
  • Pharmacists today are educated and trained with other health care providers and graduate with a Doctorate of Pharmacy degree, which requires six to eight years to complete.

Do pharmacists provide these services now?

  • As part of the healthcare team, pharmacists can play an important role in addressing provider shortages, managing patients’ chronic conditions and related medications, and coordinating among providers.
  • Pharmacists also help in the transition to population-based care and to advance Medicare’s triple aim “to achieve better care for patients, better health for our communities, and lower costs through improvement for our health care system.”3

[1] Medically Underserved Areas, Health Professional Shortage Areas, and Medically Underserved Populations are designated by the Federal Health Resources and Services Administration based on population-provider ratios. See datawarehouse.hersa.gov/geoadvisor/shortagedesignationadvisor.aspx.

[2] F.Isasi and E. Krofah. The Explanding Role of Pharmacists in a Transformed Health Care System

(Washington, D.C.: National Governors Association Center for Best Practices, January 13, 2015).

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