New law recognizes Washington pharmacists as medical providers

By Regence
December 13, 2016

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

Washington consumers may consult with pharmacists on some medical services under Washington Senate Bill 5557. Previously, this law was restricted to select pharmacists who work at facilities with whom Regence has network contracts. Starting Jan. 1, 2017, the law expands to include pharmacists in hospitals, clinics, nursing homes and community pharmacies such as Walgreens or your neighborhood pharmacy.

The new law allows pharmacists to provide some medical services already covered within your medical insurance benefit. In those instances, the pharmacist might ask for your medical insurance card and submit a bill for these services like other health care providers. This means you could be subject to a copay or coinsurance.

This doesn’t mean that any conversation with your pharmacist will result in a separate bill. Talking with your pharmacist about a prescription or the routine dispensing of medication is covered as part of your pharmacy benefit. However, pharmacists providing covered medical services such as immunizations, tobacco cessation counseling or who work with your doctor or other providers to help you manage a chronic illness, like asthma, could bill for those services. Keep in mind, in order for pharmacists to bill for these services, they must be enrolled in the Regence Participating or Regence Preferred Provider Networks.

If you have questions about your bill, call Member Services at the number on the back of your member ID card.