Radiologists urge Congress to quash bill that would ‘inappropriately’ grant pharmacists more authority

Radiologists are urging Congress to quash a bipartisan bill that would “inappropriately” grant more power to pharmacists in the hopes of boosting seniors’ access to care.

Lawmakers in the House and Senate introduced the Equitable Community Access to Pharmacist Services Act last year. The legislation would allow Medicare to reimburse for certain pharmacist-administered tests, treatments and vaccinations for influenza, RSV, COVID-19 and strep throat “in accordance with state scope-of-practice laws.”

It’s been a year since the U.S. Senate unveiled its version of the bill, with no passage since then. However, the legislation has now “amassed a considerable number of co-sponsors,” the American Society of Neuroradiology noted Tuesday. With momentum building, ASNR, the American Medical Association and others believe it is “important to show unified opposition within organized medicine.”

“Scope expansions like the one proposed in this bill would only add further responsibilities to an overburdened pharmacist workforce and threaten patient safety due to their insufficient training in these activities,” over 90 medical societies wrote to leaders in the House and Senate July 23. “Furthermore, each member of the physician-led healthcare team has an important role to play while working together to ensure improvements in patient care. H.R. 1770/S. 2477 would allow pharmacists to test, treat and, therefore, initiate drug regimens for COVID-19, influenza, RSV or streptococcal pharyngitis. This extensive list has the potential to vastly expand pharmacists’ scope of practice beyond state licensure laws that have been thoughtfully put in place, most often by the state board of pharmacy.”

Others signing the letter included ASTRO, the American College of Radiology, Association of Academic Radiology, the Society of Interventional Radiology and all 50 state medical societies. Doc groups emphasized that they “greatly value the contribution of pharmacists to the physician-led care team.” However, their training is “substantially less extensive than that of physicians,” who undergo four years of medical school, upward of seven years of residency, and as many as 16,000 hours of clinical training. Conversely, pharmacists are required to complete four years of education, with no residency and 1,740 hours of training.

“Equally concerning,” radiology groups wrote, is the fact that pharmacists in the community setting already are overworked. About 71% in chain settings and 91% of those in community-based locations rated their workload as “high or excessively high,” according to survey data. The most common “highly stressful” job aspects included “having so much work to do that everything cannot be done well” (43%), working at current staff levels (37%) and “fearing that a patient will be harmed by a medication error” (35%).

“The policy changes outlined in H.R. 1770/S. 2477 should be rejected because they will further stress the federal healthcare system that is already under-resourced and riddled with fiscal problems,” the letter concluded. “Misdiagnoses, siloed and uncoordinated care, and patients not receiving the right care at the right time all lead to worse patient outcomes and add costs to our healthcare system. We should respect the success of coordinated team-based care and put patient safety first by rejecting the misguided approach in this legislation.”

Reps. Adrian Smith, R-Neb., Brad Schneider, D-Ill., Larry Bucshon, MD, R-Ind., Doris Matsui, D-Calif., Earl L. Carter, R-Ga., and Diana Harshbarger, R-Tenn., introduced the House bill in March 2023. It now has 131 co-sponsors in the lower chamber. Meanwhile, Sens. John Thune, R-S.D., and Mark Warner, D-Va., introduced the Senate version in July 2023, gaining 24 co-sponsors. The bill is supported by the National Rural Health Association and the Future of Pharmacy Care Coalition, a group representing pharmacies serving millions each day across the U.S. Members of the group include the American Pharmacists Association, Abbott, AmerisourceBergen, Cardinal Health, CVS, Kroger, McKesson, the National Association of Chain Drug Stores, Walgreens, Walmart and others.

“This bipartisan bill recognizes that pharmacists are a trusted, reliable and accessible healthcare provider for Medicare beneficiaries and empowers pharmacists in all settings to continue to care for vulnerable senior communities—particularly those in rural and underserved areas across our country,” the coalition said in a statement last year.