States seeking pharmacist reimbursement system
States seeking pharmacist reimbursement system
NABP, Mississippi model expanding
Five states are entering contracts with the National Association of Boards of Pharmacy (NABP) in Park Ridge, IL, to establish pharmacist credentialing tests for disease state management reimbursement, based on the Medicaid plan established last summer in Mississippi.
Ohio, Louisiana, Alabama, Rhode Island, and Oklahoma are seeking to offer pharmacist exams in diabetes, asthma, anticoagulation, and dyslipidemia clinical pharmacy, in anticipation of setting up a pharmacist reimbursement system for those services that is similar to the Mississippi plan.
Credentialing and reimbursement bloomed last summer when the Health Care Financing Administration approved a plan by Mississippi’s Medicaid program and state pharmacy board to begin paying pharmacists for clinical disease management in the four disease state areas, provided a credentialing process was in place.
To get that done, the Mississippi board turned to the NABP, the National Association of Chain Drug Stores, and the National Community Pharmacists Association. The three groups merged as the National Institute for Standards in Pharmacist Credentialing (NISPC) and began establishing credentialing standards.
Soon after, though, 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. But based on a two-day conference on the issue last September that was hosted by seven national pharmacy organizations not a part of the new NISPC, a consensus plan has been reached allowing input by various organizations into the credentialing process under the NABP umbrella.
The meeting 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.
The process has opened the door for more state pharmacy boards to set up testing and approach individual state Medicaid programs on the possibility of reimbursement. "The interest level and support among individual pharmacists is quite high. Several pharmacy schools have also said they support what we’re doing and asked how they can assist and work with their state boards," says Carmen Catizone, NABP executive director.
Adds Alabama pharmacy board secretary Jerry Moore, "We hope we can convince the third parties that this is a good way to do it. It’s a mechanism by which the pharmacy board can protect the public health and practitioners can get reimbursed for their cognitive services."
In another expanding area of clinical pharmacy, that of specialty certification, the national Board of Pharmaceutical Specialties (BPS) in Washington, DC, added 367 pharmacists to its certification rolls based on 1998 test results, buoyed by its first offering of certification testing in oncology pharmacy.
Specifically, 118 of 207 pharmacist candidates passed oncology certification tests. In the four other specialties BPS offers, 32 pharmacists became credentialed in nuclear pharmacy, bringing the total number of certifications to 431; 14 passed nutrition support pharmacy tests for a total of 506 pharmacists certified; 166 passed pharmacotherapy, bringing that number to 1,413 certified; and 37 more pharmacists became certified in psychiatric pharmacy, bringing the total to 265 pharmacists certified in psychiatry since testing began in 1992.
The board began offering nuclear pharmacy certification in 1978 and nutrition support and pharmacotherapy certifications in 1988.
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