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Laura Hanen, CPNP Government Affairs Representative
Senior Vice President, District Policy Group, Washington DC

The COVID-19 pandemic has understandably become the central focus of health policy in Washington since late February. There have been four COVID-19 relief packages signed into law:

On May 15, the House passed the Health and Economic Recovery Omnibus Emergency Solutions Act (Heroes) Act (H.R. 6800), a $3 trillion COVID-19 relief bill that includes additional relief for health care providers. With no Republican support for the bill in the House, negotiations have yet to begin with the Senate and the White House on a bipartisan package. Senate Majority Leader McConnell (R-KY) has publicly stated that he would rather the Senate focus on examining the impact of the funds that have been/ are continuing to be distributed to learn what is most needed. The likely timeline for a 5th relief package is just prior to the 4th of July recess.

CPNP Advocacy

CPNP has engaged on a variety of fronts to advocate for legislation and regulations related to COVID-19 from expanding pharmacist scope of practice to increasing access to treatment for mental health and substance use disorders. CPNP engages in advocacy on its own and in coalition with other organizations. These coalitions include the Patient Access to Pharmacists’ Care Coalition (PAPCC), the Mental Health Liaison Group (MHLG), the Partnership for Part D Access, and the Health Professions and Nursing Education Coalition (HPNEC).

Pharmacist Scope of Practice and COVID-19 Testing:

CPNP meeting weekly with fellow Joint Council of Pharmacy Practitioner (JCPP) organizations to advocate with policymakers for emergency scope of practice expansion, ensure payment for those services, and advocate for personal protective equipment for pharmacists. This has included virtual meetings with federal agencies such as the Food and Drug Administration (FDA) and the Center for Medicare and Medicaid Services (CMS) and the issuance of a number of joint letters.

On April 12, HHS authorized licensed pharmacists to order and administer COVID-19 tests approved by the FDA. As a result, CPNP has been engaged with a broad array of pharmacy stakeholder organizations seeking clarification on the policy from CMS in terms of pharmacists’ ability to bill for testing and testing related services under Medicare. While this is a narrow expansion of pharmacy scope of practice, this is an opportunity to get the foot in the door for direct reimbursement for pharmacists’ services under Medicare.

Unfortunately, CMS maintains that it is constrained by current law that pharmacists cannot be considered Medicare providers and will only receive payment for COVID-19 testing if enrolled in Medicare as a laboratory, in accordance with a pharmacist’s scope of practice and state law. Pharmacists can work with a physician or other practitioner to provide assessment and specimen collection services, and the physician or other practitioner can bill Medicare for the services under an “incident to” arrangement.

CPNP with its coalition partners appealed to Congress to establish pharmacists as providers under Medicare Part B to provide COVID-19 and flu testing during the public health emergency. CPNP also joined a letter requesting a meeting with Admiral Brett Giroir, the Assistant Secretary for Health at HHS and the agency point person for COVID-19 testing, to discuss barriers to reimbursement for pharmacists under Medicare and the potential impact on the expansion of wide-spread point-of-care testing.

Expanding Access to Behavioral Health Care:

CPNP has joined with mental health coalition partners to advocate for increased access to mental health and substance use disorder (SUD) treatment and care to address the needs of patients during this unprecedented public health crisis and beyond. While Congress and the Administration have taken action to expand access to behavioral health services under Medicare via telemedicine, CPNP is supporting in coalition a similar expansion by private health plans and Department of Defense’s TRICARE plans.

In an important advance for SUD treatment, the Drug Enforcement Administration loosened remote prescribing restrictions during the public health emergency, enabling providers to prescribe controlled substances using telemedicine. CPNP submitted comments supporting DEA’s proposed rule to expand access to medication assisted therapy through narcotic treatment programs’ mobile units.

Funding for Workforce Training:

CPNP continues to support funding for the Health Resources and Services Administration’s Title VI health professions programs including Mental and Behavioral Health and Behavioral Health Workforce Education & Training. In addition, CPNP joined pharmacy associations in recommending inclusion of pharmacists for student loan forgiveness under the recently introduced “Student Loan Forgiveness for Frontline Health Workers Act” (H.R 6720).

Telling Our Story

CPNP continues to seek out opportunities to highlight the inconsistent and generally inadequate reimbursement of psychiatric pharmacist services and the significant barrier this imposes to ensuring patients and other healthcare providers have access to their services across the hospital outpatient, physician office and specialty treatment settings. 

CPNP will be submitting comments on the following in the coming weeks:

  • The Bipartisan Policy Center’s Behavioral Health Integration Task Force call for comments to inform policy recommendations to improve the integration of primary and behavioral health care to achieve better health outcomes. CPNP will highlight the role of psychiatric pharmacists as a key member of the healthcare workforce and the reimbursement barriers that impede greater access and utilization of their services. The Bipartisan Policy Center is an influential think tank in Washington, DC.
  • CMS announced the release of an Interim Final Rule with Comment (IFC) to provide additional flexibilities to health providers and systems to address the COVID-19 pandemic. Of interest to CPNP is the expansion of audio-only telemedicine to include many more behavioral health services with payment rates similar to office and outpatient visits.
  • The 2021 Physician Fee schedule and Part B payment policies are expected to be released in early summer and will also be an opportunity for CPNP to advocate for psychiatric pharmacy.
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