5 states broaden reimbursement for pharmacists

Expanded reimbursement for pharmacist services is something industry professionals and organizations like the American Society of Health-System Pharmacists have long advocated for, but it can be complex to execute, researchers have said. But since 2023, several states have passed legislation broadening the scope for such.

"A broad coalition of stakeholders including states, the federal government, pharmacy organizations, and other parts of the health ecosystem, working together, can better address the health needs of a state and its Medicaid beneficiaries," researchers wrote in a 2021 National Library of Medicine publication. "Pharmacist practitioners across different settings of care can augment public health efforts, as well as primary and specialty care practices. State efforts should include enrollment and reimbursement of pharmacist practitioners as Medicaid providers for pertinent Medicaid-covered services." 

The five most recent states to expand the scope of reimbursement for pharmacists are:

  1. Maryland — The state's general assembly passed a bill that "requires both Medicaid and state-regulated commercial insurance plans to recognize pharmacists as providers and reimburse for all covered services within their scope of practice," according to ASHSP.

  2. Missouri — As of April 1, Missouri's Medicaid program allows "pharmacists to receive reimbursement for any covered service that falls within their scope of practice."

  3. North Dakota — As of April 6, the state passed an act that will expand patient access to comprehensive medication management and "requires coverage for licensed pharmacists to provide" such care.

  4. Virginia — State legislators signed a law March 23 that requires Medicaid to "reimburse pharmacists for any covered service provided under a collaborative agreement or statewide protocol."

  5. Wyoming — In February, Wyoming passed a law that as of July 1, will now give "reimbursement for services provided by pharmacists under Medicaid within their scope of practice."

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