Advancing Coverage of and Payment for Pharmacists’ Services in the Medical
Benefit
Pharmacists’ patient care services improve health outcomes for patients,
increase access to clinical services, and support team-based care models. Increasingly, health
plans are seeking to cover pharmacists’ services that align with state scopes of practice or
standard of care models under the medical benefit. Once a covered benefit for patients has been authorized,
pharmacists may enroll and be credentialed as plan network providers and submit claims for payment for the patient care services
delivered. APhA is working with pharmacist members and leaders and health plan partners to
navigate these paths for you. Check out the information to support advancing coverage of and
payment for pharmacists’ services.
Optimizing Patient Outcomes
APhA previously hosted a convening of pharmacists and health plans to define
the value of pharmacists to health plans, barriers to covering pharmacists’ services, and scalable
solutions for coverage of pharmacists’ services under the medical benefit.
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PROCEEDINGS
Recommendations for Pharmacists and Health Plans
As health plan representatives and pharmacist practitioners start dialogue or
continue conversations to advance coverage of pharmacists’ patient care services under the
medical benefit, reference these Recommendations from thought leaders for components to
include and lessons learned to apply.
SEE
RECOMMENDATIONS
Advocacy Action Center
There continues to be strong momentum in state and federal legislatures to
expand programs that recognize and pay for pharmacists’ patient care services. Take action today
through APhA’s Advocacy Action Center to urge your elected officials to support increased access
to pharmacist-provided care.
TAKE
ACTION