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Pharmacists as Providers
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Pharmacists as Providers of Patient Care 

 

Passage of Landmark Legislation: SB 5557

After decades of fighting for recognition as care providers, we finally have a victory to celebrate! As you may have heard, ESSB 5557 has passed with overwhelming bipartisan support from the legislature and Governor Jay Inslee (D) signed the bill into law on Monday, May 11th, 2015.

ESSB 5557 is the missing link for pharmacists to get recognized as providers by health insurance plans. The legislation requires health insurance carriers to recognize pharmacists in the same way as other providers such as physicians, nurse practitioners, and physician assistants. Sponsored by Senator Linda Evans Parlette, this landmark law will be the first of its kind in the country to increase patient access to medical care from pharmacists practicing within their scope of practice.  

We are proud that Washington State pharmacists continue to lead the way in providing innovative, quality care to patients.


Understanding the Bill

Timelines:

January 1, 2016: Health plans that have delegated credentialing agreements with provider organizations are required to include pharmacists in their participating provider networks and pay medical claims for covered services within the pharmacists scope of practice.


January 1, 2017:
Health plans are required to have an "adequate" number of pharmacists in their participating provider networks and pay medical claims for covered services within the pharmacists scope of practice.

FAQ for ESSB 5557
 

ESSB 5557 Bill Language 

Washington Bill Tracker for ESSB 5557


ESSB 5557 Legislative Deliverables from Workgroup

Over the summer of 2015, WSPA staff and members worked with other stakeholders on the ESSB 5557 Collaborative Workgroup directed by the Legislature and Office of the Insurance Commissioner to determine guidance directives for implementation of the legislation. On December 1st, 2015 the Workgroup completed their work. Below are the cover letter and three documents that were the conclusion of their work. 


Letter to the Insurance Commissioner

ESSB 5557 FAQ and Definitions

Pharmacist and Other Providers Expectations

Health Plan Policy Directives


WSPA Pharmacists as Providers Implementation Workgroups

In order to assist our members with the knowledge and tools necessary to implement this legislation in their practice, the WSPA has created four Implementation workgroups.

 

Contracting, Credentialing and Privileging: Determine best practices and tools for credentialing and privileging pharmacists. 


Billing, Coding, and Documentation: 
Determine best practices to ensure pharmacists meet billing and documentation standards, and provider tools to facilitate the billing of services through contracts with health plans.


Outcomes and Research: 
Determine the metrics to measure and report quality and outcomes of using pharmacists to provider patient care.

 

Infrastructure: IT and Communications: Determine guidelines to integrate technology in pharmacy practices to ensure interoperability, billing and payment, practice management, and documentation. 

 

If you are interested in participating in the Implementation Workgroups, contact Jenny Arnold jenny@wsparx.org for more information.

 

The WSPA Implementation Workgroups are currently building tools resources to assist WSPA members as we navigate this brave new world to be released Fall 2016.

 

Check out our Resource Centers for tools to help you contract, credential and bill for your services:

 

WSPA Contracting and Credentialing Resource Center

 

WSPA Billing Patient Care Services Resource Center

 

 

If you have any questions, please don’t hesitate to contact us at 425-228-7171 or askwspa@wsparx.org.




 

more Calendar

12/14/2016
Webinar: Optimizing Immunosuppression Using Pharmacokinetics

12/16/2016
WSPA Residency Program Directors and Coordinators Roundtable

2/1/2017
Vaccinating Adults and Adolescents: An Immunization Program for Pharmacists

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