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Health insurance companies are beginning to pay for more prescriptions written by pharmacists as ...
[+] more states ease prescribing rules. Health insurance companies are beginning to pay for more prescriptions written by pharmacists as more states ease prescribing rules. The expansion of reimbursement and health insurance coverage of prescriptions written by pharmacists comes following so-called “test to treat” legislation, which bestows prescribing status on pharmacists.
Such state laws are sweeping the country as more lawmakers pass legislation that expands the role of pharmacists to prescribe certain medicines. Health insurers see an opportunity to make sure their patients get needed prescriptions quicker in an effort to improve health outcomes. Thus, insurers are paying pharmacists as they have physicians in states where laws allow for such expanding prescribing.
Take Cigna, one of the nation’s largest health insurers, which recently began covering prescriptions written by pharmacists. “Cigna Healthcare is working to provide options and greater access to care by expanding reimbursement for pharmacists to provide certain routine medical services based each state’s regulations,” the health insurer unit of The Cigna Group said in a statement. As state legislative sessions wrap up for the summer, several states are expanding pharmacists’ “scope of practice” to allow them to prescribe amid a shortage of primary care physicians and other healthcare workers.
“Pharmacists can be a front door to basic health care for many people who might otherwise go without it, especially in areas where communities are experiencing shortages of primary care doctors,” Cigna Healthcare said. Supporters of the expansion of scope of practice rules to allow pharmacists to prescribe and provide more medical care include independent pharmacists as well as big retail pharmacy operators including Amazon, CVS Health, Walgreens and Walmart. These laws come as drugs become increasingly specialized and a shortage of primary care physicians threatens quick access to medical care while retailers look to offer more healthcare services inside their stores and online.
New Galaxy S25 Ultra Exclusive Teases Samsung’s Ambitious Plans UFC 308 Loses One Of Its Best Main Card Fights ‘FROM’ Season 3, Episode 1 Review: A Terrifying Return To The Creepiest Show On TV As one example, Illinois Gov. J.B.
Pritzker in June signed into law healthcare legislation that included an amendment to the state Pharmacy Practice Act that allows pharmacists to test, screen and then prescribe for influenza, Covid-19, group A Streptococcus, also known as strep throat, respiratory syncytial virus (RSV), adult-stage head louse and “health conditions identified by a statewide public health emergency,” the legislation says. Insurers say coverage of prescriptions written by pharmacists varies from state to state depending on the scope of practice rules but the medicines prescribed tend to be limited. Blue Cross and Blue Shield of Illinois, a unit of Health Care Service Corp,, said the Illinois plans “covers certain professional services provided by pharmacists,” a company spokesman said.
“Coverage may vary based on plan type and applicable law.” Physicians are opposing these changes to pharmacist scope of practice rules, saying the push by big retailers is prioritizing profits over patients. “Pharmacists are not generally trained to diagnose or prescribe,” Dr.
Piyush I. Vyas, president of the Illinois State Medical Society said earlier this year when lawmakers were debating the scope of practice expansion in Illinois. “One-off visits with a pharmacist do not provide an opportunity to offer follow-up care, nor do they begin to approximate the critical relationships patients have with their highly-trained physicians who have access to patients’ records to develop an appropriate treatment plan.
Equally important, many “test to treat” models fail to provide safe spaces that protect patient privacy.”.
