Generate Traction + Demand Action for Provider Status

For years, community pharmacists have offered patients the most accessible and affordable forms of care. Whether it be to fill a prescription, administer annual flu shots, or offer specialized services, pharmacists see patients more often than any other provider. In fact, patients visit their local community pharmacist an average of 35 times per year. This is compared to specialists and outpatient providers, who patients visit an average of 9 times per year, and physicians, who they only see 4 times per year.

In addition to being accessible, pharmacists work to provide patients with low-cost medications and services, which help mitigate rising healthcare costs. As more and more patients struggle to afford the care they need, pharmacists can, and do, step in.

Pharmacists and Clinical Services

Because they are so accessible and affordable, pharmacists are particularly important when it comes to clinical care. By offering similar services to physicians and other providers, pharmacists ensure that more patients get the treatment they need. In the process, they build their business and increase their revenue. Given these benefits, it is no surprise that almost 60% of independent pharmacies today offer clinical services. Compared to 5 years ago, when only 36% of pharmacies offered them, it is clear that clinical services are on the rise. Some of the most popular services include:

  • Health screenings
  • Point-of-care testing
  • Expanded immunization programs
  • Long-acting injectable drug administering
  • Pharmacogenetic testing
  • Medication therapy management (MTM)
  • Treatment of minor ailments
  • Prevention and wellness education

Understanding Legislation

Despite pharmacists’ expanding range of care, they still do not have the provider status they deserve. Currently, 37 states acknowledge pharmacists as providers under the requirements of Medicare Part B, but national legislation has complicated administration and reimbursement processes — limiting pharmacists’ ability to get paid for their services. In addition, 1/4 of states do not acknowledge pharmacists as healthcare providers at all, further threatening the future of clinical care.

As of now, there are more than 40 pieces of legislation under consideration — both on the state and federal levels — that would acknowledge and expand pharmacists’ role as healthcare providers. The most promising piece of legislation is H.R. 2759/S. 1362, also known as the Pharmacy and Medically Underserved Areas Enhancement Act. This bill, which was introduced to the U.S. House of Representatives on April 22, 2021 and the U.S. Senate on April 26, 2021, has the potential to change the way that pharmacists are perceived in the healthcare world.

If passed, the bill would grant pharmacists provider status at the federal level and enable them to bill Medicare Part B for services within their states’ scope of practice, especially in medically underserved areas. In effect, the bill would allow pharmacists to receive the compensation they deserve and better serve their communities, especially those with underserved populations.

Taking Steps to Change

While bills like the Pharmacy and Medically Underserved Areas Enhancement Act offer a promising start to the future of clinical care, there is much to be done to get there and much to be done afterward. In order for pharmacists to be able to provide high-quality services, get reimbursed for them, and receive the recognition they deserve, several steps need to be taken.

  1. Broaden pharmacists’ scope of care — To receive all of the privileges of provider status, pharmacists must be able to offer a variety of services and treatment options — or, in other words, increase their scope of care. With so many pharmacists already providing or becoming interested in clinical care, it is essential to expand into other areas. This would allow pharmacists to do more of what doctors, nurses, and specialists do, putting them on an even playing field. Some states, like California, Oregon, Florida, and Tennessee, are already taking initiative by allowing pharmacists to dispense certain medications (like contraceptives, epinephrine, and travel meds) without prescriptions — which paves the way for other state governments to do the same.  
  1. Increase reimbursements — If pharmacists are going to offer clinical services, and work to expand them, they need to be reimbursed accordingly. Bills like the Pharmacy and Medically Underserved Areas Enhancement Act are positioning legislation to do so. Under this bill, pharmacists would be reimbursed 85% of the Medicare physician fee schedule, which is consistent with reimbursements for physician assistants and nurses. Regardless of the legislation, though, paying pharmacists is a necessity in achieving provider status.
  1. Collaborate with other providers — In order to create a more unified healthcare system, providers of all kinds need to work together. Not only does collaboration allow patients to get better care, but it helps other professionals reimagine the role of the pharmacist and see them as equally qualified providers. With other professionals on their side, pharmacists have better leverage in getting the status they deserve.
  1. Receive government recognition — The final, and most important, step to provider status is getting recognition on both the state and federal levels. Bills like the Pharmacy and Medically Underserved Areas and Enhancement Act are opening up opportunities for government recognition, and with your help, they can be implemented, which will drastically change the future of pharmacy.


Watch this clip from the Catalyst Pharmacy Podcast, featuring PPCN Director Stephanie McGrath. The term “provider status” is about more than just a label. It’s about getting recognition from other healthcare providers and health plans, and giving credit where credit is due. McGrath and her team have been working with health plans to pinpoint where crucial health interactions happen so that pharmacists can get paid for their services.


Playing Your Part: What You Can Do to Help

If you are looking to push along legislation and see real change in the way that pharmacists are perceived as healthcare providers, you can take action today.

To begin with, subscribe to organizations like the American Pharmacists Association, the American Society of Health-System Pharmacists, and the National Community Pharmacists Association, who are leading the effort towards pharmacist provider status. They can equip you with the latest news and help you find ways to get involved.

In addition, you can contact Congress via the APhA’s pre-written advocacy alert. Use this resource to ask your representatives to cosponsor legislation supporting provider status, particularly the Pharmacy and Medically Underserved Areas and Enhancement Act. For a more personalized approach, schedule a meeting with your local congressman to discuss the issue of provider status.

Finally, spread the word online, on social media, and in your business. Alongside other pharmacists and like-minded people, you can generate traction and demand action.


PioneerRx fully supports the individuals and organizations who are working to further the provider status movement. We are committed to enhancing the value of community pharmacy and clinical services with our technology — and are constantly looking for ways to help enhance your practice with our pharmacy software system.


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