If you spend time with people who work in the health care field, you’ll quickly recognize a common denominator: all of us feel a tremendous responsibility to help others. That’s one of the things that motivated me to pursue a career as a pharmacist in the first place.

While delivering care certainly looks a bit different these days, my colleagues and I remain committed to helping the patients who come to us for assistance, whether they’re picking up a medication refill, receiving a vaccination or troubleshooting an issue with their insurance coverage. 

At St. Matthews Community & Specialty Pharmacy, we also offer treatments to help people who are working to address their substance use disorders (SUDs). But access to all these services could be at risk if our elected officials in Frankfort don’t pass important legislation this session.

House Bill 48, sponsored by Rep. Danny Bentley, solves a problem that pharmacists have been facing for years. But with the pandemic stretching health care resources thin and demand for pharmacy services continuing to rise, we cannot kick the can down the road any longer.

Despite the important role pharmacists play in the health care system, Kentucky lacks a mechanism to properly reimburse them for many of the critical services they provide to their patients, including the potentially life-saving SUD treatment we offer at St. Matthews.

HB 48 establishes a claims submission process that ensures pharmacists are reimbursed for the same services for which other care providers are reimbursed. Insurance companies would no longer be able to deny reimbursement to a pharmacist for providing a service or procedure within the pharmacist’s scope of practice if that same service or procedure is covered by the plan when provided by a physician, advanced practice nurse or physician assistant.

We’re not asking for special treatment. The legislation does not expand pharmacists’ scope of practice or mandate equal pay for pharmacists and physicians. It simply ensures pharmacists are reimbursed for the services they are already providing to patients — services that are helping to manage chronic health conditions, lead to better health outcomes, prevent hospitalizations, and at St. Matthews Community & Specialty Pharmacy, are helping people reach long-term remission and recovery from substance use disorders. It’s time for insurance companies to recognize pharmacists as valuable members of the care team and reimburse us as such.

Many Kentuckians struggling with addiction have come to depend on their pharmacists for the medications they need to achieve remission and sustained recovery. And, with HB 48, even more pharmacists would be incentivized to offer these services.

In recent years, we’ve seen many community pharmacies shut their doors. Reimbursement issues and other unfair insurance practices have been a major part of the equation. Now, due to the pandemic, these businesses are continuing to struggle under new financial pressures. Unless legislators pass HB 48 and remedy this reimbursement issue quickly, we run the risk of driving more pharmacies out of business at a time when they’re needed most.

At the end of the day, House Bill 48 is about protecting the patient/pharmacist relationship that so many people have come to rely on. It’s about ensuring patients can access the care they need, close to home. It’s about building a healthier Kentucky — and that’s something all of us, especially right now, should be able to get behind.

 

CHRIS HARLOW, PharmD, BCGP is Director of Pharmacy Services and co-founder of St. Matthews Community & Specialty Pharmacy in Louisville, and a former president of the Kentucky Pharmacists Association.

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