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Bill to let pharmacists bill Medicaid for clinical services draws support from health centers and pharmacies
Summary
SB118 would require Nevada Medicaid to cover clinical services provided by pharmacists when the same service is covered for other providers, enabling pharmacists to bill Medicaid for care such as medication therapy management, point‑of‑care testing and collaborative practice services. Supporters said it would expand access in primary care deserts
Sen. Jeff Stone presented Senate Bill 118, which would create Medicaid payment pathways for clinical services provided by pharmacists when the same services are covered for other authorized health professionals. Stone and witnesses emphasized that the bill does not expand pharmacists’ scope of practice; rather it creates a mechanism for Medicaid to reimburse pharmacists for clinical services they already are authorized to provide under Nevada law or collaborative practice agreements.
Ken Kunke of the Nevada Pharmacy Alliance described clinical services delivered by pharmacists — medication reviews, blood‑pressure checks, chronic disease management and point‑of‑care testing — and said that pharmacists receive extensive clinical training during their PharmD programs. He told the committee Nevada lacks the billing codes or a reimbursement mechanism that would allow pharmacists to be paid by Medicaid for many of those services, which limits widespread adoption despite demonstrated benefits when pharmacists are integrated into care teams.
Multiple speakers testified in support. Adam Porath (Nevada Society of Health System Pharmacists) explained that collaborative practice models can produce improved outcomes and return on investment; the Nevada Primary Care Association and Nevada Health Centers said Medicaid reimbursement would enable health centers and clinics to expand pharmacist‑led services to underserved patients. Retail and community pharmacists from Las Vegas and Henderson also testified that they already deliver many of these services and that Medicaid payment would remove a current financial barrier and reduce pressure on emergency departments.
Senators asked about liability and whether Medicaid would require changed provider types or federal waivers. Stacy Weeks from DHHS said a separate waiver would not be required; the department already maintains a Medicaid provider type for pharmacists, and the change would involve adding or enabling billing codes for covered clinical services.
Ending note: the hearing closed with broad support and a request that the department and stakeholders coordinate on fee schedules and billing codes for Medicaid implementation in advance of work session deliberations.
