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Some Washington pharmacists qualify as health-care providers

By Regence | December 15, 2015

If you are under a doctor’s care for management of a chronic illness, you now have another resource to help with your care.

Starting Jan. 1, 2016, Washington consumers may consult with select pharmacists on some medical services under Washington Senate Bill 5557. The new law designates select pharmacists as stand-alone medical health care providers. This means that they can submit a separate bill for some medication management services, which could be subject to a copay or coinsurance.

The law applies only to select pharmacists who work at facilities with whom Regence has network contracts and where a pharmacist also has certain credentials. In 2017, however, the law expands to include pharmacists at commercial pharmacies such as Walgreens.

This doesn’t mean that any conversation with your pharmacist when picking up a prescription will result in a separate bill. Conversations with your pharmacist about a new prescription or routine dispensing of medication would not be billed under the new law. However, pharmacists working with physicians or other providers on clinical matters as part of helping you manage a chronic illness, like asthma, could bill for those services.

Regulators continue to work on how the law will be implemented, including the scope of services that apply. If you have questions about your bill, give us a call at the number on the back of your member ID card. 

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