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The Equitable Community Access to Pharmacist Services Act would allow pharmacists to diagnose and treat certain conditions

Sept. 27, 2024 (ACP) -- The �ܼ�����ˮ��̳ is strongly opposed to federal legislation that would expand the scope of practice of pharmacists and allow them to diagnose and treat a limited number of conditions such as influenza, COVID-19 and strep throat.

Proposed legislation “could lead to potential unintended consequences that could result in fragmented care and poor health outcomes for patients,” Dr. Omar T. Atiq, immediate past president of ACP, wrote in a recent letter to several congressional leaders.

Specifically, ACP opposes a Senate bill called the Equitable Community Access to Pharmacist Services Act, which would establish Medicare Part B direct reimbursement for pharmacist services for COVID-19, influenza, respiratory syncytial virus (RSV) and strep throat. ACP also opposes companion legislation in the House.

During the COVID-19 pandemic, Congress temporarily allowed pharmacists to provide certain medical services to address the rising number of patients needing care, according to George Lyons Jr., Esq., ACP director of legislative affairs. The legislation would make these changes permanent.

The legislation is unique because it greatly expands pharmacist prescription power nationally. Some states currently allow pharmacists to prescribe medications in certain situations, Lyons said, and all U.S. pharmacists can now prescribe the COVID-19 treatment nirmatrelvir/ritonavir (Paxlovid) to appropriate patients.

Supporters of the legislation include pharmacist associations and drugstore chains. “Those who are championing this legislation claim it is needed to ensure prompt and continued access to essential pharmacist services for seniors and rural communities,” Lyons said. “They maintain that the legislation will help ensure older Americans can access essential services from pharmacists -- all within existing scope of practice -- while improving patient outcomes and reducing hospitalizations and unnecessary costs across the health care system.”

However, “ACP is concerned that this bill could undermine the physician-led, team-based care models proven to be most effective in improving quality, efficiency and patient health,” Lyons said. “Fragmentation of care remains one of the biggest challenges in our health care system. Granting independent diagnosis and prescription authority for pharmacists to treat the flu, COVID-19, strep throat and other similar conditions without coordinating with a physician who is trained to provide comprehensive care will exacerbate health disparities and disrupt the continuity of care.”

Lyons added that ACP strongly supports arrangements in which the pharmacist is part of an integrated, team-based approach to care, such as a patient-centered medical home.

According to Lyons, the legislation may be considered by the House Ways & Means and Energy & Commerce committees this fall. ACP has activated grassroots efforts to defeat the legislation and has lobbied against it with members of the committees. Allies may join the effort. Previously, the American Academy of Family Physicians and American Academy of Pediatrics worked with ACP to oppose an earlier version of the legislation.

The legislation's “fate is hard to predict as it has many cosponsors and a broad spectrum of support from third parties. That's balanced against a cost that is likely to be in the range of the low billions of dollars,” Lyons said. “There are some discussions on Capitol Hill of tying this legislation as a package to Medicare physician payments, an approach ACP opposes.”

Back to the September 27, 2024 issue of ACP Advocate