340B & Payment Reform: Advocacy Updates
- Pharmacists are playing an increasingly critical role in evolving health care models, requiring focused advocacy efforts, according to Tom Kraus, vice president of government relations at ASHP.
- kraus emphasized the importance of pharmacists actively engaging in advocacy to shape policy and advance their profession.
- For health system pharmacists, protecting services subsidized by the 340B program is paramount, Kraus said.
Tom Kraus unveils vital advocacy priorities in this update,emphasizing pharmacists’ evolving role in healthcare. Protecting the 340B programme, a key focus, demands immediate attention to secure its sustainability against potential reimbursement cuts and rebate models. Explore the necessity of expanding payment pathways for pharmacist services through state-level initiatives and Medicare Advantage plans. Actively engage in advocacy to propel your profession forward, and discover the practical steps outlined to make a tangible difference. News Directory 3 provides an inside look at how pharmacists can influence policy and embrace new opportunities. Learn about ”incident to” payment avenues and the potential of collaboration with physician groups. Discover what’s next for pharmacists.
pharmacists’ Evolving Role: Advocacy Priorities and Payment Pathways
Updated June 18, 2025
Pharmacists are playing an increasingly critical role in evolving health care models, requiring focused advocacy efforts, according to Tom Kraus, vice president of government relations at ASHP. Kraus highlighted key priorities, including safeguarding the 340B Drug Pricing Program and pursuing expanded payment avenues through state-level initiatives and medicare Advantage opportunities.
kraus emphasized the importance of pharmacists actively engaging in advocacy to shape policy and advance their profession. He offered practical advice for pharmacists and students to make a difference.
For health system pharmacists, protecting services subsidized by the 340B program is paramount, Kraus said. He noted the program faces risks from shifts to rebate models and potential reimbursement cuts.
“If you’re a health system pharmacist,clearly protecting our support for services that are subsidized by the 340B program—that’s very vital,” Kraus said. “I think that is at risk for some of the reasons around shifting to a rebate model.”
Kraus sees significant opportunities in state-level payment expansions for pharmacist services. He urged pharmacists in other states to advocate for similar changes, educating policymakers about the national trend.
Beyond Medicare provider status, Kraus pointed to “incident to” payment as another avenue for recognition. This mechanism allows physicians to bill for services provided by team members, including pharmacists. However, current rules limit reimbursement for pharmacist services to the lowest evaluation code, even for complex medication management.
Kraus suggested collaborating with physician organizations to advocate for changes to CMS,allowing physicians to bill for the full range of pharmacist-provided services. He emphasized that this approach doesn’t require legislative changes.
The rise of Medicare Advantage presents another opportunity.Kraus noted that these plans can reimburse pharmacists as patient