Radiologists say bill to grant pharmacists more authority could have ‘dangerous long-term consequences’
Radiologists say a new bipartisan bill, granting pharmacists more practice authority, could have “dangerous long-term consequences,” if passed by Congress.
Sens. Mark R. Warner, D-Va., and John Thune, R-S.D., recently reintroduced the Equitable Community Access to Pharmacist Services Act after representatives did the same in the House earlier this 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.”
However, the American College of Radiology and American Society of Neuroradiology are expressing concern about the proposal. They joined 30 other national healthcare societies and nearly every state medical association in penning a letter to lawmakers, asking them to reject the legislation.
“The bill has numerous shortcomings,” the neuroradiology society said in an Aug. 8 news update announcing its opposition. According to ASNR, concerns include “inappropriately allowing pharmacists to perform services that would normally only be authorized and covered if they were furnished by a physician, testing and treating patients for certain illnesses and expanding Medicare payment for pharmacists in limited but significant ways.”
Lawmakers also introduced the Equitable Community Access to Pharmacist Services Act in the previous Congress a year ago, but it failed to pass. They’ve made some modifications this time around, but radiologists and other physicians believe the proposal presents the same problems. Doc groups emphasized 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.
ACR, ASNR and others are “particularly concerned” the bill would permit pharmacists to evaluate and manage patients for the testing or treatment of COVID-19, influenza, RSV, or streptococcal pharyngitis. Such diagnoses require a comprehensive physical exam pharmacists are not qualified to deliver. The most recent version of the bill proposes allowing these allied professionals to do so through a “collaborative practice agreement” with physicians. But the doc groups contend it is unlikely real, meaningful collaboration would occur in these community-based pharmacy settings.
“Physician-led, team-based care has a proven track record of success in improving the quality of patient care, reducing costs, and allowing all healthcare professionals to spend more time with their patients,” ACR, ASNR and others wrote to Reps. Adrian Smith, R-Neb., and Brad Schneier, D-Ill., the lead sponsors of the House bill, on July 24. “We are concerned that the policy changes within H.R. 3164 conflict with this approach to healthcare delivery and could result in patients forgoing holistic wellness exams, comprehensive preventive care, early diagnosis and optimal therapy, which could have devastating long-term consequences.”
On the other side, lawmakers believe the legislation will help to fill care gaps, particularly in rural communities. Pharmacists “stepped up to meet urgent healthcare needs” during the pandemic, especially in isolated geographies facing provider shortages, senators said.
“This bill builds on that progress by making sure seniors can continue to count on their local pharmacists for routine tests, vaccines, and treatments for common illnesses like flu and COVID,” Sen. Warner said in a statement July 24. “This is a practical step to improve access to care, reduce the burden on hospitals and clinics, and make our health system work better for seniors.”
The legislation now has 48 co-sponsors in the House and eight in the Senate. Groups such as the South Dakota Pharmacists Association, Virginia Pharmacy Association and the Future of Pharmacy Care Coalition are supporting the legislation. The latter is a coalition that includes the American Pharmacists Association, Abbott, AmerisourceBergen, Cardinal Health, CVS, Kroger, McKesson, the National Association of Chain Drug Stores, Walgreens, Walmart and others.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.