COLUMBUS, Ohio — Gov. Mike DeWine declared last week that Ohio pharmacists will be able to provide COVID-19 tests, but you may want to call ahead before rushing to your neighborhood drug store.
“As frontline health care providers, pharmacies are critical in our state’s response to this pandemic,” DeWine said at a May 28 press briefing.
But many community pharmacists say they are not able to provide the service because the state has not set up a system for pay them for administering the tests, which can cost up to $100 each.
That means the coronavirus testing by pharmacies is funneled to the major chains such as CVS, which already has the necessary provider number status issued by the state.
Denise Conway, who owns pharmacies in Mount Vernon and Danville, said every day she has patients and employers ask if she can provide antibody testing for coronavirus.
“We still don’t have provider status in the state of Ohio to allow us to bill patients’ insurance companies as a provider,” she said. “So it’s not reimbursable through someone’s medical insurance right now. (We can give the test but) they have to pay cash.
“Ohio is behind the times right now in the pharmacy world of allowing and getting pharmacists the provider status that we need in order to be that integral part of our health care system.”
Long before the coronavirus outbreak, Ohio lawmakers passed legislation in January 2019 to begin compensating pharmacists for medical services in addition to dispensing medications. But more than a year after the law took effect, the Department of Medicaid has yet to set up provider identification numbers for pharmacists to allow for payment like other health-care providers.
“When things like this come up unexpectedly you want to be ready and we’re certainly not ready to use that vast network of pharmacies to help us solve a problem, not to mention all of the other things they could have been doing up until now not related to the virus,” said Rep. Mark Romanchuk, R-Mansfield, and vice chairman of the Joint Medicaid Oversight Committee. “It’s a shame.”
In a recent letter to Medicaid Director Maureen Corcoran, Romanchuk questioned the delay and urged the department to speed implementation of the law.
“The intent of this “provider status” is to tap the untapped expertise of Ohio’s pharmacists, and to begin utilizing them for their clinical knowledge rather than their speed of churning out prescriptions,” Romanchuk wrote.
Ohio’s independent pharmacies have been hard hit by low payments to fill prescriptions for Medicaid patients, contributing to the closure of nearly 400 pharmacies in recent years and creating pharmacy deserts in under-served and disadvantaged communities across the state. The financial hardship has forced many that remain open to scale back services and interactions with doctors and patients, Romanchuk noted.
In addition, pharmacies continue to wait for the Medicaid agency to distribute their share of $100 million lawmakers authorized nearly a year ago to help offset losses from low reimbursements
Pharmacies in Ohio that are providing coronavirus testing, including CVS, have in-store clinics already authorized as providers that they can use for billing. Last week, CVS opened 34 COVID-19 test sites at select CVS pharmacy drive-thru locations across the state under its MinuteClinics, said company spokesman Joseph Goode.
“There are 2,000 pharmacies in Ohio and there might be 100 or 200 max that are doing any form of testing, and that’s because they are not being compensated,” said Antonio Ciaccia, lobbyist for the Ohio Pharmacists Association.
“Pharmacists have the legal authority to order and administer tests. There are no legal barriers … Medicaid has sat on implementing the policy for almost 18 months.”
Medicaid officials gave no indication of when the issue would be resolved.
“The governor’s recent remarks underscore that (pharmacies) are critical in helping us achieve the goal of expanded testing,” said Medicaid spokeswoman Lisa Lawless.
New guidance from he Ohio Board of Pharmacy “clarifies the role of pharmacists in testing for COVID, allowing them to order and administer the test,” she said. “With new guidance, we are considering the implications and will be discussing potential next steps with pharmacies, pharmacists and other stakeholders.”
Conway said the types of services pharmacists are now authorized to provide include chronic disease management, lab tests and drug administration.
“It could be so quick and convenient and cost saving for if the patient,” she said. “How much could we save our health-care system and free up our primary care providers?”