Expand Scope of Pharmacist-Provided Patient Care Services in Acute and Primary Care Settings

• Empower pharmacists to provide clinical services commensurate with their training and consistent with the standard of care
• Advocate for a greater role of pharmacists in responding to the opioid epidemic, including authorization to initiate and manage buprenorphine and other medications for opioid use disorder (MOUDs)
• Enable pharmacists to play a greater role in supporting access to comprehensive reproductive and sexual health services
• Better leverage pharmacists to manage chronic disease
• Encourage adoption of institutional privileging and collaborative practice arrangements that position pharmacists to lead the management of medication therapy across healthcare settings
• Support the adoption of innovative state collaborative practice authority
• Increase patient access to pharmacogenomics testing to support comprehensive medication management (CMM)

Secure Payment for Pharmacist-Provided Patient Care

• Collaborate with pharmacy, healthcare, and patient organizations to highlight the value of pharmacists and pharmacy technicians within the healthcare team
• Advocate for recognition of pharmacists as providers across payers, including individual and group coverage, Medicare, and Medicaid
  • Advocate for the inclusion of pharmacists as a credentialed provider in payer contracts and agreements
  • Advocate for enhanced payment models, including value-based payment that includes pharmacists and pharmacies in payer networks
  • Secure payment for pharmacist-provided CMM across payers, including CMM informed by pharmacogenomics
  • Advocate for payment of pharmacist-provided services for conditions such as substance and opioid use disorders, diabetes, cardiovascular disease, pre- and post-exposure to sexually transmitted infections, respiratory viruses, and vaccine-preventable diseases
  • Support the ability of Medicare Advantage plans to include pharmacists in their provider networks
  • Ensure pharmacists are treated equitably as patient care providers in payer networks
  • Advocate for insurers, including individual and group coverage, Medicare, and Medicaid, to cover pharmacist-provided telehealth and population health services
• Make permanent flexibility for virtual supervision of pharmacists within the Medicare program
• Allow pharmacist services provided incident to a physician to be billed consistent with the complexity of services provided

Advocate for Solutions to Pharmacy Workforce Challenges

• Advance efforts to support pharmacists’ roles in public and population health, and educate the public on the essential role of pharmacists in those fields
• Protect funding for pharmacy postgraduate year 1 (PGY1) residencies and expand funding to postgraduate year 2 (PGY2) residencies
  • Prepare residency programs to respond to pass-through funding audits
  • Allow residency programs to collaborate with health systems and schools of pharmacy while receiving Medicare funding
  • Secure funding for specialized PGY2 residencies and community-based residencies
  • Advocate for interstate pharmacist licensure to expand the ability of pharmacists to practice across state borders
• Advocate for policies that support the well-being and mental health of the pharmacy workforce
• Promote policies to reduce the debt burden for graduating pharmacists
• Advocate for workplace safety measures to protect the pharmacy workforce
• Ensure adequate supply of health-system pharmacy workforce

Promote the Role of Qualified Pharmacy Technicians

• Support efforts to recruit and retain the pharmacy technician workforce
• Advocate for the creation and development of advanced roles for pharmacy technicians
• Support pharmacy technician recognition and licensure by every state
  • Advocate for pharmacy technician education and accredited training programs
  • Advocate that all pharmacy technicians obtain and maintain Pharmacy Technician Certification Board certification
• Advocate for qualified pharmacy technicians to fully participate in product preparation, final physical product verification, and dispensing activities
• Allow pharmacy technicians to fully engage in the sterile compounding process
• Expand the scope of services provided by pharmacy technicians, such as medication reconciliation, vaccine and medication administration, and specimen collection for laboratory testing
• Advocate for pharmacy technician representation on state Boards of Pharmacy
• Advocate for affordability and accessibility of training programs for pharmacy technicians seeking career advancement

Protect Patient Access to Safe and Affordable Medications

• Work with federal agencies and other organizations to strengthen the drug supply chain and reduce the burden of drug shortages
  • Provide increased transparency throughout the drug supply chain
  • Advocate for federal incentives to support the purchase of vulnerable medications through long-term contracts
  • Encourage federal support for private-sector buffer supplies of critical medications
• Advocate that the Food and Drug Administration (FDA) adopt health-system compounding regulations consistent with U.S. Pharmacopeia beyond use guidelines
• Oppose state barriers to the adoption of technologies that support health-system compounding practices
• Advocate for Congress to adopt policies that encourage generic and biosimilar competition and support patient access to affordable medications
• Collaborate with the FDA to curb manufacturer risk evaluation and mitigation strategy program abuses that undermine generic competition or restrict health-system pharmacy access to medications
• Advance prior authorization reform

Address Societal Barriers to Patient Care

• Advocate for policies to address health disparities within the healthcare system, including disparities in access to medication therapy
• Encourage policymakers to utilize pharmacists to meet patient care needs in medically underserved areas
• Advocate for patients’ access to comprehensive reproductive, sexual, and gender-affirming healthcare services
• Allow for pharmacists to be actively involved in reducing the negative effects of substance abuse disorder on society, health systems, and the pharmacy profession
• Advocate for optimal suicide awareness and prevention efforts focused on both patients and the healthcare workforce
• Protect against pharmacy and hospital closures

Protect the Sustainability of Health-System Pharmacy

• Defend and preserve the 340B Drug Pricing Program supporting patient access to care
  • Support the reintroduction and passage of the PROTECT 340B Act and 340B PATIENTS Act
  • Ensure implementation of Medicare drug price negotiation preserves the cost savings of the 340B program and does not increase medication purchasing costs for hospitals and pharmacies
  • Support litigation to defend the 340B program in court
  • Encourage federal agencies to take enforcement actions against drug manufacturers that violate the law by restricting access to discounted products, imposing inappropriate requirements on covered entities as a condition of receiving discounts, or converting 340B discounts to rebates that disadvantage healthcare providers
  • Collaborate with state affiliates to introduce model legislation prohibiting payers from discriminating against 340B covered entities
  • Encourage state adoption of ASHP’s model legislation to protect 340B contract pharmacy relationships
  • Protect the 340B program from onerous restrictions imposed by drug manufacturers
• Ensure that pharmacy benefit managers (PBMs) can no longer undermine patient care or health-system pharmacy sustainability
  • Require transparency into PBM practices, fees, and structures
  • Support state and federal legislation prohibiting payer-mandated “white bagging,” “brown bagging,” or other similar tactics
  • Prohibit PBMs from engaging in spread pricing to capture the difference between medication cost and pharmacy reimbursement
  • Prohibit PBMs from basing patient cost sharing on drug list prices
  • Oppose PBM rebates that distort payer formularies and medication pricing
  • Prohibit payers from excluding health-system pharmacies from specialty pharmacy networks
  • Prohibit insurers and PBMs from applying inappropriate fees to specialty pharmacies
  • Prohibit payers from imposing site of care restrictions or penalties for pharmacy services
• Ensure health-system access to limited distribution drugs
• Defend against direct and indirect remuneration fees and other punitive retroactive fees on pharmacies
• Oppose the application of inappropriate primary care metrics to health-system specialty pharmacies
• Oppose payment policies that reduce reimbursement of medication administration in hospital outpatient departments, particularly when those policies fail to account for increased costs required to safely prepare and administer sterile products and hazardous medications
• Advocate for policies that reduce the burden of payer prior authorization requirements on patient care

About ASHP

ASHP is the largest association of pharmacy professionals in the United States, representing 60,000 pharmacists, student pharmacists, and pharmacy technicians in all patient care settings, including hospitals, ambulatory clinics, and health-system community pharmacies. For over 80 years, ASHP has championed innovation in pharmacy practice, advanced education and professional development, and served as a steadfast advocate for members and patients. In addition, ASHP is the accrediting body for pharmacy residency and technician training programs and provides comprehensive resources to support pharmacy professionals through every stage of their careers. For more information, visit ashp.org and ASHP's consumer website, SafeMedication.com.