Pharmacy organizations merge on credentialing

Disease-specific, national standards are pursued

It appears as though a cease-fire has been called by pharmacy organizations jockeying to lead the industry into pharmacist credentialing for government reimbursement, based on a set of credentialing initiatives involving 10 national organizations that as recently as last fall were divided into separate camps.

The rush to credentialing began last summer when the Baltimore-based Health Care Financing Administration (HCFA) approved a plan by Mississippi’s Medicaid program and state pharmacy board to begin paying pharmacists for clinical disease management of asthma, diabetes, anticoagulation, and dyslipidemia, provided a credentialing process was in place.

To get that done, the Mississippi board turned to the National Association of Boards of Pharmacy (NABP), the National Association of Chain Drug Stores (NACD) and the National Community Pharmacists Association (NCPA). The three groups merged as the National Institute for Standards in Pharmacist Credentialing (NISPC) and established the first set of plans to institute just such a set of standards.

A verbal war soon followed, as organizations like the American Pharmaceutical Association (APhA) and American Society of Health-System Pharmacists (ASHP), for example, balked at the idea that just three organizations could or should set the standards.

Consensus plan reached

But now, based on the outcome of a summit meeting hosted by seven national pharmacy organizations not part of the NISPC, a consensus plan has been reached within the groups that also extends an olive branch to the NISPC. "The organizations plan to seek the assistance of the NISPC . . . and believe the oversight and certification activities in this announcement are largely complementary to those announced by NISPC," reads a consensus statement that came out of the summit. That summit, held in Washington, DC, in late September 1998, was hosted by APhA, ASHP, the American Association of Colleges of Pharmacy, American College of Apothecaries, American College of Clinical Pharmacy, American Society of Consultant Pharmacists, and the National Council of State Pharmacy Association Executives.

Along with reaching consensus on issues and establishing a set of goals at the meeting, members also heard a consultant’s report on the subject funded by state pharmacy boards in Iowa, Michigan, Minnesota, Missouri, South Carolina, Texas, and Washington.

In addition to attempting to make peace with NISPC, the summit’s hosting organizations have announced plans to establish a joint Council on Credentialing in Pharmacy and a certification body to administer skills testing. More importantly, it also will attempt to bring all pharmacy groups into the fold. And along with bringing in NISPC, the seven organizations will extend invitations to the Board of Pharmaceutical Specialties, the Pharmacy Technician Certification Board, and the Commission for Certification in Geriatric Pharmacy to tap into organizations already involved in certification.

Calls for national standards

The seven summit organizations say that national, voluntary standards should be established. Such standards would avoid turning off payers, and reduce confusion among different states. The organizations also say that certification should be disease-specific, something the NISPC has already pursued.

Beyond that, the groups plan to examine certification done in other medical fields to plumb for ideas, and examine issues of post-licensing recertification.

"There is a significant amount of activity in pharmacy related to training and credentialing," says ASHP executive vice president Henri Manasse. "This is an important step in addressing the public’s need for help in managing drug therapy, but it is causing confusion in the marketplace and among other health professionals. We believe a coordinated approach is needed to guide pharmacy through the development of certification and determine the relationship among the profession’s various credentialing activities," he says.

(Editor’s note: For more background on pharmacist credentialing efforts, see the October 1998 issue of Drug Utilization Review.)