Pharmacist provider status legislation signed by Governor Kasich!
The legislation will become effective 91 days after it is filed with the Secretary of State's office.
OPA worked extensively with lawmakers and stakeholders to evolve the perception of the profession of pharmacy beyond its traditional roots in order to reflect the reality of its more service-oriented role. Now, with Senator Dolan's SB 265, we have changed key provider definitions and insurance laws to catch up to the growing role of the pharmacist.
"By including pharmacists as medical professionals with provider status, we are permitting pharmacists to practice at the top of their license," said Senator Dolan. "Pharmacists learn and train with physicians in our universities, but are not able to practice this collaborative spirit in the field; this bill allows for that."
The impetus for better utilizing all members of the health care team has never been greater. Ohio suffers from a litany of medically underserved areas, and doctor shortages are expected to get even worse in the coming years. As the demands for health care services grows, the need for tapping into "physician extenders" and the full health care team increases exponentially.
The pharmacist profession has evolved considerably in recent years, and while their scope has increased, barriers to utilizing pharmacists in the field persist. Much of the barriers are due to old laws, antiquated billing models, and regressive attitudes on health care delivery. But enactment of SB 265 is a significant opportunity to change this. In light of the opioid crisis, increased chronic disease costs, and growing behavioral health demands, SB 265 will help knock down the barriers that have stood in the way of health plans, hospitals, and health care teams from integrating and utilizing the pharmacological expertise of the pharmacist.
In 2015, the National Governors Association (NGA) released an extensive report entitled "The Expanding Role of Pharmacists in a Transformed Health Care System," that called on states to revise their laws to "better integrate pharmacists into the health care delivery system and allow them to practice to the full scope of their professional training."
"As the health care system undergoes a major transformation in both finance and the delivery of services, states are focusing on improved quality and health outcomes," said NGA Executive Director Dan Crippen. "Integrating pharmacists, who represent the third largest health profession, into the health care delivery system is one way to meet those goals."
When the pharmacist focuses on medication education, adherence, and prevention of adverse drug events, better health can be achieved. Even the American Medical Association has begun to acknowledge the key role of the pharmacist on the health care team. The facts speak for themselves: Ohio pharmacists provide care.
Recently the Ohio Pharmacists Foundation and OPA's Medication Therapy Management Committee worked to develop "Ohio's MTM Story," a comprehensive guide to the value of pharmacist services across the state of Ohio. This directory, organized by Ohio Senate district, was created to showcase the effect of patient interactions with pharmacists. Each MTM “story” speaks to an individual encounter that improved the health of a patient, and shows the positive influence that a pharmacist can have on the healthcare system and patient lives. This booklet was an excellent guide to educate lawmakers and members of the public on the value of pharmacist services, and thus the need to enhance access to those services.
While Ohio's MTM Story contains real-world examples of pharmacist services, many of these encounters occur without a reimbursement mechanism for the service rendered. To ensure these services can continue, to increase the prevalence of these forms of pharmacist care, and to better incentivize the creation of innovative care models, provider status is a fundamental need.
"The signing of SB 265 is a landmark victory for the profession of pharmacy," said OPA President Ryan Schneider. "This begins the next chapter in the evolution of the profession as pharmacists will now be recognized as providers of healthcare in the State of Ohio, which will allow for compensation for cognitive services. I would like to thank OPA members, OPA staff, and the various leaders in the profession for their efforts to provide testimony and lobbying support to make this possible. This brings us one step closer to more fully recognizing the value of pharmacists as an integral member of the healthcare team."
"OPA has won the battle to get pharmacists recognized as providers in Ohio law," said OPA Executive Director Ernie Boyd. "This groundbreaking legislation opens the door in both private and Medicaid programs for advanced pharmacy services to be reimbursed. We thank the many OPA members who have testified, come to legislative days, and contacted their legislators to make this vote happen. We also thank Governor Kasich for signing this important legislation and Senator Dolan for leading the charge."
"It has been a long journey to recognize pharmacists as providers," said OPA Immediate Past President Cathy Kuhn. "With the signing of SB 265, we are at a pivotal point for pharmacists’ roles on the healthcare team and the recognized impact they have on patients. It has been truly a team effort by OPA staff, past and current leaders, and all of those who testified and contacted their legislators. Thank you especially to Senator Dolan for believing in the value of the services pharmacists provide!”
"As President of OPA in 2016, I announced that provider status legislation for pharmacists was my top priority," said OPA Past President Chet Kaczor. "It is incredibly rewarding to see this proposed legislation come to fruition. Governor Kasich's signing of SB 265 is the culmination of years of discussions and effort to help patients gain greater access to pharmacists’ services."
"SB 265 is a philosophical step into a more service-oriented role for pharmacists, but it also enhances patient access to care," said OPA Director of Government & Public Affairs Antonio Ciaccia. "We look forward to the new, innovative ways that health plans will empower pharmacists to improve patient outcomes."
OPA thanks Senator Dolan for his acknowledgment and passion to promote and grow the role of the pharmacist as a mechanism to improve health care outcomes in Ohio. We appreciate Governor Kasich for his endorsement as well. At a time when our state needs as many tools as possible to combat our pressing health care challenges, ensuring that pharmacists — the medication experts — are a usable option in the toolbox is essential.
Special thanks to Senator Dolan, his staff, and the Legislative Services Commission for their tireless work with us to craft and refine the language in SB 265. Additional thanks to the Ohio Society of Health-System Pharmacists (OSHP) for some of the resources and studies that we will be using to make our case to lawmakers. We'd also like to thank Representatives Scott Lipps, Sarah LaTourette, Bill Blessing, Speaker of the House Ryan Smith, and Senate President Larry Obhof, who went to bat for the bill in the House and pressed for its passage prior to the close of the General Assembly. And of course, thanks to Senator Dave Burke for his instrumental support as we worked to create and advance the legislation in the Senate - this bill does not happen without him. Lastly, thanks to OPA Board Trustee Tony Ciaccia from University Hospitals in Cleveland for bringing this issue to Senator Dolan and inspiring him to carry the bill in the first place.
We would like to thank the number of pharmacists and other proponents who delivered testimony in support of SB 265 over the last year. Those individuals and their testimony are linked below:
Dana Bachmann - Kroger Pharmacy
Kelli Barnes - The Ohio State University Division of General Internal Medicine
Debra Barnette - The Ohio State University College of Pharmacy
Stu Beatty - The Ohio State University College of Pharmacy
Jackie Boyle - Northeast Ohio Medical University
Tony Ciaccia - University Hospitals
Antonio Ciaccia - Ohio Pharmacists Association
Edward Clack - Western Medicine Inc.
Angela Corbett - Ohio State University Physicians Internal Medicine and Pediatrics
John Covello - Independent Pharmacy Cooperative
Jacob Dean - Western Medicine Inc.
Julie DiRossi-King - Ohio Association of Community Health Centers
Senator Matt Dolan
Julie Ehemann - Shelby County Commissioner
Steve Ferris - Discount Drug Mart
Denise Gormley - University of Cincinnati College of Nursing
T.J. Grimm - The Centers for Families & Children
Melody Hartzler - Western Medicine, Inc.
Renee Hebbeler-Clark - University of Cincinnati College of Medicine
Britni Lookabaugh - OhioHealth Riverside Methodist Hospital
Lora Miller - The Ohio Council of Retail Merchants
Ohio's MTM Story
Jen Rodis - The Ohio State University College of Pharmacy
Richard Shell - Nationwide Children's Hospital
Erin Thompson - University of Findlay College of Pharmacy
Joseph Tobias - Nationwide Children's Hospital
In addition to containing these important provider status provisions, we are also pleased to report that the language from SB 56/HB 72, which would make needed reforms to step therapy, was also added to SB 265 while being deliberated in the House. OPA is supportive of the provisions to streamline step therapy for Ohio patients, and we're happy that they are now also going to be enacted into Ohio law thanks to Governor Kasich's signature.
This does not happen without the support of OPA members. Please join us in our work to grow the profession of pharmacy.