Magazine article Drug Topics

Mississippi Milestone

Magazine article Drug Topics

Mississippi Milestone

Article excerpt

In a landmark decision, the Health Care Financing Administration (HCFA) has decided to pay pharmacists in Mississippi for providing pharmaceutical care services to Medicaid patients. This makes Mississippi the first state in the country to use the "other licensed practitioner" approach to get payment for R.Ph.s' nondispensing services.

Under this approach, Medicaid will pay pharmacists to perform medical services as licensed practitioners who are not doctors, provided they are operating within their scope of practice.

Services for four disease states will be covered in Mississippi-anticoagulation, diabetes, asthma, and hyperlipidemia. The actual reimbursement rate, however, is still under negotiation. Reportedly, HCFA plans to pay R.Ph.s the same rate it pays physicians-about $20$25 per visit.

Now that approval is granted, other states are expected to use Mississippi as a starting point, if not model, to secure funding from HCFA. What are the key elements to Medicaid payment for pharmaceutical care? David Schulke, director of alliance development and regulatory affairs at the American Pharmaceutical Association, noted the following requirements at the recent APhA annual meeting in Miami Beach:

Specify the services (such as lab tests and blood draws) that pharmacists will provide.

If there is a counseling component, explain how it differs from drug utilization review and what physicians provide. Obtain a referral and plan of care from the patient's physician.

Explain what courses pharmacists must take or credentials they must have before they can provide the services. …

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