Reimbursement for pharmacist services.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Appropriations
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to standardize reimbursement rates for pharmacist services in California’s Medi-Cal program. Specifically, it seeks to equalize the reimbursement for advanced practice pharmacist services with that of physician services, including medication therapy management (MTM). The bill also updates the requirements for health care service plans and disability insurers to cover advanced practice pharmacist services, aligning them with existing coverage for similar services provided by other licensed healthcare providers. Finally, it modifies the Medi-Cal program to ensure appropriate reimbursement for pharmacist services, particularly those related to specialty drugs.
Key provisions
- Requires reimbursement for advanced practice pharmacist services at the same rate as physician services, including MTM.
- Updates health care service plans and disability insurers to cover advanced practice pharmacist services.
- Modifies the Medi-Cal program to ensure reimbursement for pharmacist services, particularly for specialty drugs.
- Establishes a medication therapy management (MTM) reimbursement methodology for covered pharmacist services related to specialty drugs.
- Requires pharmacists to be enrolled as ordering, referring, and prescribing providers under Medi-Cal.
- Authorizes the department to seek federal approvals for implementing the changes.
- Defines ‘medication therapy management’ and ‘specialty drugs’ for the purpose of the bill.
- Provides an exception to reimbursement requirements if the change would create a new crime or infraction.
Bill text
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Sponsors
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1 on record
Primary sponsor
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