The American Pharmacists Association (APhA) is calling upon the federal Coronavirus Task Force to make greater use of pharmacists in combating the novel coronavirus (COVID-19) outbreak. In a letter addressed to Vice President Mike Pence, the APhA requested modifying or temporarily waiving certain Medicare, Medicaid, and Children’s Health Insurance Program requirements outlined in Section 1135 of the Social Security Act in order to expand pharmacists’ authority in responding to COVID-19.

“Pharmacists are well-positioned to provide information and educational resources related to coronavirus to the public. We can do more,” states the letter, signed by APhA Executive Vice President and CEO Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA. “America’s pharmacists stand ready and able to provide the patient care services necessary to help meet the public health needs created by the spread of the coronavirus.”

By Wednesday afternoon, APhA officials had not received a response from the task force. Ilisa Bernstein, PharmD, JD, FAPhA, senior vice president, pharmacy practice and government affairs for APhA, expressed the organization’s disappointment in an email to Pharmacy Times®.

“Pharmacists are front-line health care providers and accessible, trained, and ready to do more to help patients, but [we] need the federal government and states to provide additional authorities, and the removal of barriers to enable us to do more. More communication from the public health officials is always welcome as this pandemic and health care response is constantly evolving,” said Bernstein.

The letter to Pence proposed modification to Section 1135 that would grant pharmacists the authority to help ensure sufficient health care items and services are made available to people in need who are enrolled in Social Security Act programs. Additionally, health care providers offering services in good faith would be reimbursed and exempted from sanctions.

In some states, pharmacists already have authority in conducting certain tests, such as influenza and strep throat, and many pharmacy professionals are providing vaccinations. APhA also noted in the letter that pharmacies are preparing to administer COVID-19 testing. Although a COVID-19 vaccine is not yet available to the public, a clinical trial is underway in Washington state.  

The letter has 4 specific requests for federal action. They include:

Allow pharmacists to administer COVID-19 tests as a rapid diagnostic test
Pharmacists could be utilized to collect samples, submit them to approved labs, interpret results and communicate them to patients, make referrals, and guide patients on prevention methods, as well as appropriate next steps. Pharmacists could also assess patients, conduct testing, interpret the results, and provide available treatment or referrals, according to CDC guidance.

Allow all pharmacies to receive a certificate of waiver and to offer the COVID-19 test as a clinical laboratory improvement amendments (CLIA)-waived point-of-care (POC) test
“In addition, under Medicare, a pharmacy may possess a CLIA Certificate of Waiver so that they may expand patient access to CLIA-waived tests and improve public health,” the letter states.

According to APhA, offering the COVID-19 test as a CLIA-waived, POC testing would assist the health care system in triaging patients and in getting treatment. The identification of patients with COVID-19 is improved by testing patients without a primary care provider and those screened outside of regular clinic hours of operation. In this regard, pharmacists can serve a vital role in combating COVID-19.

Recognize and use pharmacists as capable vaccine providers for the COVID-19 vaccine when it becomes available
Pharmacists are already playing a critical role in increasing vaccination rates for influenza, according to the APhA. The organization is requesting that the task force encourage and work with states to remove barriers to pharmacists and other health care professionals to administer a COVID-19 vaccine, which is still being developed.

The letter to Pence cites an additional 4.1 million adults vaccinated in 2013 due to states allowing pharmacists to administer the flu vaccine. Those 4.1 million vaccinations resulted in 81,000-134,000 fewer influenza infections. The odds that an adult would receive a flu vaccine increased by 7.8% in states that allowed pharmacists to immunize patients.

Remove administrative barriers that impact pharmacists’ delivery of care for patient preparedness
The APhA is urging the task force to implement uniform measures that would remove or waive any administrative barriers on pharmacists and patients for accessing early medication refills. These early refills would help ensure that patients have the medications they need for chronic conditions during the COVID-19 pandemic.

Some states and payers have taken steps to authorize pharmacists to dispense emergency refills or waive early medication refill limits.


For up-to-date information on COVID-19 for pharmacy professionals, visit Pharmacy Times' coronavirus resource center.


REFERENCE

Menighan T. Letter Re: APhA Recommendations to the President’s Coronavirus Task Forxe to Maximize the Use of Pharmacists to Prevent, Treat, and Respond to Coronavirus. Created March 13, 2020. Accessed March 18, 2020.