APhA Policy Manual

1. Pharmacists are health care providers who must be recognized and compensated by payers for their professional services under medical benefit payment structures.
2. APhA supports integration pharmacists' provision of health care services into existing standardized processes under the medical benefit.
3. APhA affirms that pharmacists’ must be compensated for their services consistent with the processes of, and in parity with, other health care providers.
4. APhA advocates for the development and implementation of a standardized credentialing process for compensation of pharmacist services.
5. APhA advocates for pharmacists’ access and contribution to clinical and claims data to support treatment, payment, and health care operations.
6. APhA supports the integration of pharmacists’ service level and outcome data with other health care provider and claims data.
7. APhA advocates for the in-network inclusion of pharmacists under medical benefits to increase access to health care services.
8. APhA opposes policies or practices that prevent or undermine billing for pharmacist-provided services under the medical benefit by any health plan, payer, pharmacy benefit manager (PBM), or other entity.

1. APhA affirms pharmacy personnel’s role in screening and referral for individuals experiencing intimate partner violence.
2. APhA supports the development of training programs and tools to aid pharmacy personnel in screening for intimate partner violence.

1. APhA supports pharmacists, as licensed health care professionals, in their use of professional judgment throughout the course of their practice to act in the best interest of patients.
2. APhA asserts that a pharmacist's independent medication review and use of professional judgment in the medication distribution process is essential to patient safety.
3. APhA opposes laws, regulations, and policies that limit a pharmacist’s responsibility to exercise professional judgment in the best interest of patients.
4. APhA calls for civil, criminal, and professional liability protections for pharmacists and pharmacies if the pharmacist’s responsibility to use professional judgment is limited by laws, regulations, and policies.

1. APhA supports pharmacist involvement in appropriate laboratory testing and health screening, including pharmacists directly conducting the activity, supervising such activity, ordering and interpreting such tests, and communicating such tests results.
2. APhA supports revision of relevant laws, regulations, and policies to facilitate pharmacist involvement in appropriate laboratory testing and health screening as essential components of patient care.
3. APhA encourages research to further demonstrate the value of pharmacist involvement in laboratory testing and health screening services.
4. APhA supports public and private sector compensation for pharmacist involvement in laboratory testing and health screening services.
5. APhA supports training and education of pharmacists and student pharmacists to direct, perform, and interpret appropriate laboratory testing and health screening services. Such education and training should include proficiency testing, quality control, and quality assurance.
6. APhA encourages collaboration and research with other health care providers to ensure appropriate interpretation and use of laboratory monitoring and health screening results.

1. APhA encourages the development and use of a system for billing of medication therapy management (MTM) services that: (a) includes a standardized data set for transmission of billing claims, (b) utilizes a standardized process that is consistent with claim billing by other health care providers, and (c) utilizes a billing platform that is accepted by the Centers for Medicare and Medicaid Services (CMS) and is compliant with the Health Insurance Portability and Accountability Act (HIPAA).
2. APhA supports the pharmacist’s or pharmacy’s choice of a documentation system that allows for transmission of any MTM billing claim and interfaces with the billing platform used by the insurer or payer.
3. APhA encourages pharmacists to use the American Medical Association (AMA) Current Procedural Terminology (CPT) codes for billing of MTM services.
4. APhA supports efforts to further develop CPT codes for billing of pharmacists’ services, through the work of the Pharmacist Services Technical Advisory Coalition (PSTAC) and Pharmacy e-HIT Collaborative.

1. APhA affirms pharmacists’ professional accountability within their role in all practice settings.
2. APhA advocates that pharmacists be granted and accept authority, autonomy, and accountability for patient-centric actions to improve health and medication outcomes, in coordination with other health professionals, as appropriate.
3. APhA reaffirms 2017 Pharmacists’ Role Within Value-based Payment Models and supports continued expansion of interprofessional patient care models that leverage pharmacists as accountable members of the health care team.
4. APhA advocates for sustainable payment and attribution models to support pharmacists as accountable patient care providers.
5. APhA supports continued expansion of resources and health information infrastructures that empower pharmacists as accountable health care providers.
6. APhA supports the enhancement of comprehensive and affordable professional liability insurance coverage that aligns with evolving pharmacist accountability and responsibility.

1. APhA supports the inclusion of pharmacogenomic analysis in the drug development/approval and postmarketing surveillance processes.

1. APhA recognizes the value of pharmacist-provided point-of-care testing and related clinical services and promotes the provision of those tests and services in accordance with the Joint Commission of Pharmacy Practitioners Pharmacists’ Patient Care Process.
2. APhA advocates for laws, regulations, and policies that enable pharmacist-provided point-of-care testing and related clinical services that are consistent with the pharmacists’ role in team-based care.
3. APhA opposes laws, regulations, and policies that create barriers to the tests that have been waived by the Clinical Laboratory Improvement Amendments (CLIA) and that are administered and interpreted by pharmacists.
4. APhA encourages use of educational programming and resources to facilitate practice implementation of pharmacist-provided point-of-care testing and related clinical services.
5. APhA supports patients taking active roles in the management of their health, including their ability to request and obtain pharmacist-provided point-of-care tests and related clinical services.
6. APhA advocates for access to, coverage of, and payment for both pharmacist-provided point-of-care tests and any related clinical services.

1. APhA supports establishment of pharmacy practice-based research networks (PBRNs) to strengthen the evidence base in support of pharmacists’ patient care services.
2. APhA encourages collaborations among stakeholders to determine the minimal infrastructure and resources needed to develop and implement local, regional, and nationwide networks for performing pharmacy practice-based research.
3. APhA encourages pharmacy residency programs to actively participate in pharmacy practice-based research network (PBRNs).

1. APhA affirms that pharmacists are the medication experts whose accessibility uniquely positions them to increase access to and improve quality of health care while decreasing overall costs.
2. APhA asserts that pharmacists must be recognized as the essential and accountable patient care provider on the health care team responsible for optimizing outcomes through medication therapy management (MTM).
3. APhA asserts the following: (a) Medication Therapy Management Services: Definition and Program Criteria is the standard definition of MTM that must be recognized by all stakeholders. (b) Medication Therapy Management in Pharmacy Practice: Core Elements of an MTM Service Model, as adopted by the profession of pharmacy, shall serve as the foundational MTM service model.
4. APhA asserts that pharmacists must be included as essential patient care provider and compensated as such in every health care model, including but not limited to, the medical home and accountable care organizations.
5. APhA actively promotes the outcomes-based studies, pilot programs, demonstration projects, and other activities that document and reconfirm pharmacists’ impact on patient health and well-being, process of care delivery, and overall health care costs.

APhA supports projects that demonstrate and evaluate various pharmacy-based screening and monitoring services.