State allowing pharmacists to enroll as Medicaid providers to expand contraception access

Earlier this month, the N.C. Department of Health and Human Services announced that pharmacists can enroll as Medicaid providers and contraceptive counseling services can be provided at pharmacies by the enrolled pharmacists.

The department said it made the change in an effort to increase access to contraception in North Carolina. Enrolled pharmacists will be authorized to prescribe various medications — such as hormonal contraceptives and prenatal vitamins — and can be listed as the prescriber on Medicaid insurance claims.

Starting on Jan. 8, pharmacies will be reimbursed for services provided by their enrolled pharmacists, as long as the pharmacist is using the state's Self-Administered Hormonal Contraceptive Protocol. The protocol consists of additional patient assessment and education, along with the pharmacist notifying the patient’s primary care provider or women’s health care provider.

In 2021, the N.C. General Assembly passed a law that authorizes pharmacists to dispense contraception without prescription from a healthcare provider. The N.C. Boards of Pharmacy and Medicine adopted protocols under which pharmacists can dispense medications without a copay or out of pocket expenses.

But, according to the NCDHHS, a lack of reimbursement created a barrier for pharmacies to implement the protocols. The new, increased support from the state aims to lessen barriers of implementation for these practices.

Tiffany Graham Barber, the owner of Hillsborough Pharmacy and Nutrition, said the protocol allows the pharmacist to assess the patient’s medical history and determine next steps for evaluation.

“It's basically just an information sheet that summarizes everything that we would need to know to be able to safely prescribe and then dispense those hormonal contraceptives,” she said.

Barber also said the new ability to bill North Carolina Medicaid for these services will help the pharmacy.

“It's going to be great for the patient population, especially since we just expanded Medicaid to be able to provide them with a quick, easy consultation to be able to access contraceptives, if they are so inclined to want that kind of service from the pharmacy,” she said.

The NCDHHS worked to expand same-day access to all types of contraception and provide Medicaid reimbursement for immediate postpartum, long-acting reversible contraception.

Amanda Savage, an assistant professor at the UNC Eshelman School of Pharmacy, said giving pharmacists the option to become Medicaid providers and providing payment for the services pharmacists administer is a large step in the right direction.

“By providing payment for that service, we're hoping that that may motivate some of our other pharmacists to start providing the service,” she said.

Mollie Ashe Scott, the regional associate dean at the UNC Eshelman School of Pharmacy, said this change has been a long time coming. She said, historically, pharmacists have not been treated as providers by insurance organizations, limiting what pharmacists are able to do.

“Having pharmacists serving as providers with Medicaid is really an advancement in pharmacy practice in our state, so we're absolutely thrilled about it,” she said.

Scott said more convenient access to resources is necessary because more than 600,000 women in North Carolina live in a “contraception desert" — an area that lacks reasonable access to a health center offering a full range of contraceptive methods.

“Even if someone doesn't have an OBGYN in their community, everybody's got a pharmacy within five miles of where they live,” she said. “So this is just one more door that we can open to allow patients to go and get health care services that they need.”

@DTHCityState | city@dailytarheel.com