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Carey Potter, CPNP Government Relations Consultant

The Present Legislative Options

Last year, CPNP joined ACCP in a coalition effort to seek recognition of comprehensive medication management (CMM) provided by qualified clinical pharmacists as part of a team-based approach in Medicare Part B. Such recognition of the benefit by pharmacists, and of specific interest to CPNP members, is the proposed definition of “qualified clinical pharmacist” which, among other criteria, acknowledges pharmacists that are certified or eligible for certification in a pharmacy practice specialty recognized by the Board of Pharmacy Specialties (BPS). Our coalition and the contracted lobbyist from the Federal Group continue scheduling meetings with members of Congress, discussing the need for CMM and the services of clinical pharmacists as part of team-based care. Thus far, actual legislation has not been introduced, but much time and energy has been put forth developing talking points and conducting the outreach to move toward bill introduction.

In early January, Senator Ron Wyden (D-OR) and three others introduced SB 1932, the “Better Care, Lower Cost Act 2014.” The legislation’s goal is to transform Medicare from a program that pays for services separately to one that pays teams of caregivers who treat the chronically ill. The legislation recognizes pharmacists as providers eligible to perform “better care practices.” CPNP and ACCP recently sent a letter commending the Senator on the bill introduction and suggested additional enhancements.

Last week, the Patient Access to Pharmacists’ Care Coalition (PAPCC) introduced HB4190.  The bill would recognize state licensed pharmacists who provide services in medically underserved areas as providers under Medicare Part B. The bill does not specify what services could be provided, but press releases have mentioned health and wellness screenings, chronic disease management, immunizations and medication management. Although CPNP supports the introduction of this bill, the organization did not join the coalition due to the requirement that the ACCP-CPNP coalition efforts would have to be terminated in order to participate (see letter regarding this decision).

The Legislative Strategy

Before legislation is introduced, much work must be done. Organizations must meet with members of Congress and their staff members to discuss the issue and to solicit sponsorship. Often legislation (the bill) is scored (analyzed for cost to the federal budget) by a professional company, to help the organization and sponsors to strategize about its content. The Congressional Budget Office (CBO) does the same scoring process once the bill is introduced and set for hearing. Then the bill is referenced to the appropriate committee in either the House or the Senate, a hearing date is scheduled and public testimony is received at that time. The Committee then votes on the proposal, sending it to Congress for further debate. 

It is not known, at this point, when SB 1932, HB 4190 or the ACCP/CPNP initiative (once the bill is introduced) will be discussed. The likelihood is that all of the proposals face a multi-year effort given mid-term elections and the current political climate. Further, it is possible that one or all of the proposals may be amended to one piece of legislation. The fate of all proposals is unknown.

CPNP will continue to monitor all Provider Status related initiatives and keep the membership apprised of this legislative process and any additional proposals that are introduced. For those of you who plan to attend the Annual Meeting, we encourage you to attend the Sunday Learning Lab dedicated to this topic as well as CPNP’s Forum on our Future (Wednesday’s retooled, interactive Business Meeting) to discuss this and the many other pressing issues and opportunities facing the profession and our association.

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