Highlight on North Dakota: Pharmacists take four more steps to provider status

Four new laws are giving pharmacists greater authority in the North Dakota. Republican Governor Jack Dalrymple signed four pieces of legislation, all of which include language granting pharmacists limited provider status.  The North Dakota Pharmacists Association (NDPhA) is celebrating the passage of the legislation as a victory for the profession and practice of pharmacists in the state.

Collaborative practice

Under the status quo in North Dakota, pharmacists have limited provider status when undertaken under a collaborative practice agreement with a physician in accordance with the state’s collaborative practice law. The requirements of a collaborative practice agreement will change under S. 2173, which expands a pharmacist’s role by eliminating the institutional requirement, allowing pharmacists to practice under a collaborative agreement regardless of practice setting. The bill also allows pharmacists to initiate and modify certain drug therapies.

Medication Therapy Management

Another bill, S. 2320, allows pharmacists to conduct medication therapy management (MTM) for Medicaid beneficiaries. The bill specifically considers pharmacists as providers who may provide MTM services in person or via telephone for Medicaid reimbursement. The MTM law will go into effect on January 1, 2016.

Status and prescription authority

The other two bills also grant pharmacists provider status under certain circumstances. Under H.R. 1102, pharmacists have provider status for the purposes of pain programs and services provided under the state’s worker’s compensation law. The last bill, S. 2104, gives pharmacists provider status and limited authority to prescribe naloxone rescue kits, which are used to prevent deaths resulting from drug overdoses.

Testimony

To get the bills passed, pharmacy organizations like the NDPhA banded together to raise awareness about the benefits of increased provider status for pharmacists. Shelby Monson, a 2015 PharmD candidate at North Dakota State University and NDPhA intern, supported the cause by testifying before the North Dakota Health and Human Services Committee. In addition to highlighting the perspective of future pharmacists, Monson testified regarding the role that pharmacists could play in the management of cholesterol-lowering medications, which typically require that a patient have a lipid panel done 4–12 weeks prior to the start of the medication.  Monson explained that “instead of going to the doctor’s office for an appointment and lab tests, the patient would be able to come into the pharmacy and have their cholesterol, LDL, and HDL checked at a pharmacy—and if necessary, the pharmacist could adjust the medication and assess for drug-related effects and [adherence] as well.”