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GUEST COLUMN CHUCK GRASSLEY Expanding medical access in rural Iowa Pharmacy and Medically Underserved Areas Enhancement Act encourages pharmacists to offer health care
Sen. Chuck Grassley, guest columnist
Apr. 8, 2016 10:20 am
Like a lot of Iowans, I grew up in a rural community. In small towns, there might be a pharmacist on Main Street but no doctor. Iowans are used to driving long distances for the doctor while having easier access to a pharmacist. It becomes natural to ask the pharmacist for all kinds of advice on medical topics, not just on how to take prescription drugs but maybe when a condition doesn't require a doctor's visit or when something on the drugstore shelf might help between doctor visits.
This is especially true for older residents. A Medicare beneficiary who lives in a rural area far from a doctor can't always get there easily. Maybe the person no longer drives, and there's no other way of getting to an appointment. But the individual might be able to get a ride from a neighbor to stop by the town pharmacy a few miles away. While there, the person is able to ask questions about a prescription or talk with the pharmacist about managing blood sugar in diabetes or high blood pressure. Maybe the individual discusses whether to get a flu shot and even gets the shot right there at the pharmacy. This kind of interaction helps the person avoid a serious illness or a hospital stay.
Yet under Medicare, doctors who give consultations and flu shots to beneficiaries are paid for their time. Pharmacists who give consultations and flu shots to beneficiaries often are not.
That strikes me as unfair and even penny-wise and pound-foolish. Pharmacists undergo many years of training. They're especially well-versed in how medication works. Surveys regularly cite pharmacist as among the most trusted professions. If money is the only concern, it's a lot less expensive to give someone a flu shot or advice on blood sugar than to treat someone with a case of the flu or a complication of diabetes. But patient welfare is the main concern, and Congress has recognized the pharmacist's role in helping Medicare beneficiaries before.
In 2003, Congress created the Medicare prescription drug benefit so that seniors would have better access to prescription medicine. I was one of the main authors. The law included a limited program to reimburse pharmacists to counsel certain patients about using medicine under their new prescription drug benefit. Some private insurance companies and Medicaid were already using this kind of program. Studies have shown that it helps make sure patients are taking their medication as directed and prevents medication errors. Both save lives and money.
The challenge is that not all Medicare beneficiaries have access to this service. That's why I introduced the bipartisan Pharmacy and Medically Underserved Areas Enhancement Act (S. 314). The bill would expand on the common sense lessons learned from the medication management Congress envisioned in creating the Medicare prescription drug benefit. It recognizes that pharmacists are providing tremendous value to Medicare beneficiaries on health care matters, and Medicare policy should reflect what's happening in the field. It's also important to note that medical professionals are already in short supply, and demands will only increase as our society ages.
The bill encourages pharmacists to offer health care services such as health and wellness screenings, immunizations and diabetes management by authorizing Medicare payments for those services where pharmacists are already licensed under state law to provide them. Most states already allow pharmacists to provide these services but there currently is no way for pharmacists to receive Medicare reimbursement for providing them. A companion bill has been introduced in the House of Representatives.
It's been gratifying to hear from more than two dozen Iowa pharmacy students on this bill. These students are committed to their hometowns and to bringing their expertise back to the pharmacies on Main Street. As one student put it, 'When passed, this act will increase the health outcomes of our medically underserved Iowans, control health care costs, and use pharmacists' clinical education in the full capacity in which we are trained.” That sounds like a win all-around.
' Sen. Chuck Grassley, a Republican from New Hartford, is chairman of the Judiciary Committee. Comments: (202) 224-3744
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