Background:

The Main Street Pharmacy Access Act, H.R.3164, formerly the Equitable Community Access to Pharmacist Services Act (ECAPS), would expand Medicare coverage for pharmacist-provided evaluation and management (E/M) services related to the testing and treatment for COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis (strep throat). The updated bill, passed out of the House Ways and Means Committee, includes expansive legislative language defining “covered pharmacists services,” which would allow pharmacists to bill for all E/M services codes, going beyond their scope of practice. This includes codes that physicians use to provide longitudinal care to patients, such as conducting physical examinations and providing chronic care management, so long as the patient is diagnosed or treated for COVID, flu, RSV, and/or strep throat. 

We need your help to prevent this bill from becoming law and authorizing Medicare payment to pharmacists for such an expansive scope of practice. Pharmacists are essential members of the care team and provide quality patient care as part of a physician-led team. Physicians work closely with pharmacists to ensure patients are prescribed safe, effective, and appropriate medications. Team-based care requires leadership, and physician expertise is widely recognized as integral to quality medical care.

ACP is concerned that this bill could significantly undermine the physician-led, team-based care models proven to be most effective in improving quality, efficiency, and patient health. We are also concerned that expanding pharmacists’ scope of practice, allowing them to treat and diagnose upper respiratory illnesses, which they are not uniquely trained for, will be detrimental for patient safety. In the short-term, it could lead to misdiagnosis and delay in much-needed care. In the long-term, it would also contribute to the fragmentation of care since pharmacists do not have access to patients’ full medical records. Granting independent diagnosis and prescription authority for pharmacists to treat the flu, COVID-19, strep throat, and other similar conditions without coordinating with a physician, who is trained to provide comprehensive care, will exacerbate health disparities and disrupt the continuity of care. Further, allowing pharmacists to provide a full range of longitudinal care services, which they do not have the education and training for, will not improve access to care, but rather, it will threaten patient safety and weaken the primary care physician workforce. 

Action Requested: Please urge your members of Congress to oppose H.R. 3164, the Main Street Pharmacy Access Act, which would permanently authorize Medicare coverage for expanded pharmacist scope of practice.

Thank you for your continued advocacy.

Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign.