Moderated by Sharon Gatewood, Pharm.D., President of the Virginia Pharmacy Association (VPha), the panelists were able to provide expert insights into recent legislative changes allowing Medicaid reimbursement for clinical services rendered by pharmacists, pharmacy interns and pharmacy technicians through DMAS. 

Opening up the event, the Center for Pharmacy Practice Innovation (CPPI) director, Teresa Salgado, Ph.D. gave an overview of CPPI's vision, mission, programs, partnerships and future goals. CPPI's mission - helping pharmacists optimize patient outcomes - is implemented through four key areas: people and partners, research, education and training and policy. 

Sharon Gatewood, Pharm.D. introduced the topic by giving a historical overview of the established statewide protocols and implications for pharmacists - beginning in 1997 with the start of pharmacist administered immunizations, the establishment of Collaborative Practice Agreements (CPAs) in 1999 to the initial implementation of statewide protocols in 2020. 

Caroline Juran, R.Ph. - executive director of the Virginia BOP - expanded on these two models of care - CPA's and statewide protocols - discussing the nuances, benefits and limitations within each model. Additionally, she detailed legal requirements and scope of statewide protocols and CPAs. 

JoeMichael Fusco, Pharm.D. - MCO Pharmacy Compliance Manager at DMAS - discussed recent legislation - VA Senate Bill 1538 - which allowed pharmacists, pharmacy interns and pharmacy technicians to receive Medicaid payment through DMAS for the clinical services provided. Recognizing the barrier many pharmacists face when enrolling in the program, Fusco offered insight regarding enrollment options, considerations, codes and resources.

As an ambulatory care pharmacist at CrossOver Healthcare Ministry, John Bucheit, Pharm.D., provided personal insight of the process and procedures for implementing the E&M codes for pharmacists recommended by DMAS, emphasizing the use of established patient codes and the overlap with CPAs. 

Tana Kaefer, Pharm.D. - Director of Clinical Services at Bremo Pharmacies - offered key information regarding the process of and prerequisites needed for enrollment as a Medicaid provider, including NPI numbers, the CLIA waiver, and Medicaid group versus individual enrollment. In addition, she discussed software options and support technologies to bill medically.

As CPPI continues to engage with these initiatives, it remains committed to achieving several key goals including:

1. Conducting research that will inform uptake and implementation of Medicaid billing for pharmacist services in Virginia
2. Enhancing partnerships with VPhA, BOP and DMAS
3. Educating pharmacists, pharmacy interns and pharmacy technicians
4. Offering support and guidance to community pharmacists and pharmacies

Visit our archive page to view event recording and slides.