The Future of Any Willing Provider Laws in Pharmacy

Ron Lanton III, Esq., executive director and senior counsel for Frier Levitt Government Affairs, provides insight into the future of Any Willing Provider laws for the pharmacy industry.

Transcript

Any Willing Provider laws have a great future, I think. Number one, I believe at last count that we did there were around 36 states that had some element of Any Willing Provider to it. And it really depends on the provider, because when Any Willing Provider started, it started in the late 90’s with the trend, and they were more responsive to the HMOs that were happening in the 90’s. And then, it kind of died off and we had another round of Any Willing Provider laws right around 2005 to 2009. That was more pharmacy focused, so it was really for a pharmacy to get into these networks.

The earlier ones, likely are applicable to pharmacies, but some states the way that their laws are written kind of have this gray area of where is it a pharmacy provider, is it not, is it a doctor that can take advantage of it? I think that the bright future is if you have states that have this gray area, they’re already on the books. If you have a statute that’s already on the books it’s a lot easier to amend than getting something brand new. So I think starting there and really understanding as a pharmacist, does this apply, if not I can just go ahead and amend it. If not I think there’s obviously more room to get pharmacies into the network and to get more bills. And obviously, Congress does have a federal Any Willing Provider for Medicare Part D underserved areas, so hopefully we can see that pass and more opportunities for specialty pharmacy.