The Legal Implications of Pharmacist Provider Status and the Transformation of an Industry

AHLA Connections November 2014

John S. Linehan, Associate in the Health Care and Life Sciences practice, in the firm’s Baltimore and Washington, DC, offices, authored an article in AHLA Connections titled “The Legal Implications of Pharmacist Provider Status and the Transformation of an Industry.” (Read the full article - membership required.)

Following is an excerpt:

The growing influence and role of non-physician practitioners have transformed health care in recent decades. Due to a host of factors, including physician shortages, the rising demand for primary care services, and the search for cost-efficiencies in care delivery, lawmakers have expanded the scopes of practice and reimbursement eligibility for certain mid-level practitioners, most notably, nurse practitioners and physicians assistants. More recently, a nationwide movement has emerged to promote the use of pharmacy services in health care delivery and to secure recognition for pharmacists as reimbursement eligible providers under the state and federal health care programs.

While momentum is building behind pharmacy groups’ lobbying efforts, widespread recognition of pharmacists as providers is not a foregone conclusion—significant debate remains over pharmacists’ role in an evolving health care landscape and whether and to what extent they deserve reimbursement for patient care services. Moreover, the potential legal and practical consequences of pharmacist provider status have not been closely analyzed or appreciated. The attainment of provider status could impart and accelerate dramatic changes to pharmacy practice and the attendant benefits and burdens could accrue unequally across the industry.