Empower Pharmacists to Provide a Broader Scope of Patient Care Services

• Expand the scope of patient care services pharmacists are authorized to independently provide, both through support for state scope of practice expansion and use of federal authority
• Encourage adoption of institutional privileging and collaborative practice arrangements that position pharmacists to lead the management of medication therapy across healthcare settings
• Advocate for a greater role of pharmacists in responding to the opioid epidemic, including by initiation and management of buprenorphine and other medications for opioid use disorder (MOUDs)
  • Encourage state adoption of ASHP's model legislation and protocol for pharmacist management of MOUDs
• Urge policymakers to make permanent the scope of practice expansions adopted during the COVID-19 public health emergency
• Build on emergency authority during the COVID-19 response by encouraging the Department of Health and Human Services (HHS) to issue Public Readiness and Emergency Preparedness (PREP) Act declarations to allow pharmacists to provide nationwide access to pre- and post-exposure prophylaxis (PrEP and PEP) for HIV, and antivirals for COVID-19 and flu
• Support the adoption of innovative state collaborative practice authority through passage of model legislation
• Increase patient access to pharmacogenomics testing to support comprehensive medication management (CMM)

Secure Payment for Pharmacist Patient Care Services

• 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 commercial insurers, Medicare, and Medicaid
• 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-led treatment of conditions such as medication-assisted treatment for opioid use disorder, PEP and PrEP for HIV, and initiating antivirals for COVID-19 and flu
• Advocate for insurers, including commercial payers, Medicare, and Medicaid, to cover pharmacist telehealth and population health services
• Make flexibility for virtual supervision of pharmacists within the Medicare program permanent
• Allow pharmacist services provided incident to a physician to be billed consistent with the complexity of services provided
• Support the ability of Medicare Advantage (MA) plans to include pharmacists in their provider networks and include pharmacist services in MA plan benefits

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
• Defend funding for pharmacy PGY1 residencies and expand funding to PGY2
  • Prepare residency programs to respond to pass-through funding audits
  • Support residency program collaboration with health systems and schools of pharmacy in compliance with Medicare requirements
• Develop coalition of organizations requesting Centers for Medicare & Medicaid Services (CMS) guidance on residency compliance
• Advocate for interstate pharmacist licensure to expand the mobility of pharmacists and their ability to practice across state borders
• Create and promote tools for members of the pharmacy workforce struggling with burnout
• 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 technician workforce
• Advocate for the creation and development of advanced roles for pharmacy technicians
• Allow remote supervision of sterile compounding when conducted by pharmacy technicians
• Expand the scope of services provided by pharmacy technicians, including vaccine administration and technician final product verification programs
  • Encourage state adoption of ASHP's forthcoming model legislation to enable technician final product verification
• Support pharmacy technician recognition and licensure by every state
  • Advocate for pharmacy technician education and accredited training programs
  • Advocate that all pharmacy technicians be required to obtain and maintain Pharmacy Technician Certification Board certification

Protect Patient Access to Safe and Affordable Medication Use

• Work with federal agencies to strengthen the drug supply chain and reduce the burden of drug shortages
• 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 to 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 (REMS) program abuses that undermine generic competition or restrict health-system pharmacy access to medications
• Advocate for the development of safe, effective, and interchangeable biosimilar medications
• Collaborate with state affiliates to pass biosimilar parity legislation to encourage the adoption of biosimilar products while reducing inventory costs on health systems

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 healthcare services and gender-affirming care
• 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
  • Support litigation to defend the 340B program in court
  • Encourage federal agencies to take enforcement actions against drug manufacturers that violate the 340B program by restricting access to discounted products or imposing inappropriate requirements on covered entities as a condition of receiving discounts
  • Work with CMS to compensate 340B hospitals for illegal reductions in Medicare reimbursement that have been overturned by courts
  • Collaborate with state affiliates to introduce model legislation prohibiting payers from discriminating against 340B covered entities when determining reimbursement
  • Encourage state adoption of ASHP's forthcoming model legislation to protect 340B contract pharmacy relationships
• Ensure that pharmacy benefit managers (PBMs) can no longer undermine patient care or health-system pharmacy sustainability
  • Support state and federal legislation prohibiting payer-mandated “white bagging” and “brown bagging” or other similar actions
  • 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
• 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.