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Committee hears SB118 to allow Medicaid payment for clinical services pharmacists already provide
Summary
Sen. Jeff Stone and pharmacist groups told the committee SB118 would not expand pharmacists’ scope of practice but would create Medicaid billing pathways so pharmacists can be reimbursed for clinical services (medication therapy management, point‑of‑care testing, chronic‑care management) and help address primary‑care shortages.
Sen. Jeff Stone (Senate District 20) introduced Senate Bill 118 to revise Medicaid coverage rules so pharmacists can be reimbursed for clinical services they are already authorized to provide under Nevada law and collaborative practice agreements.
"SB 118 does not expand the scope of practice for pharmacists. These are services that pharmacists already are authorized to provide under existing law," Stone told the committee.
Why it matters: Proponents said Nevada has a shortage of primary care providers and pharmacists are an underused clinical workforce. Creating a billing mechanism under Medicaid would allow more widespread provision of chronic‑care management, medication therapy management (MTM), point‑of‑care testing and other patient‑centered services in community and clinic settings.
Key testimony and details:
- Ken Kunke (Nevada Pharmacy Alliance) explained the bill’s mechanics: Medicaid should cover pharmacist‑provided clinical services if those same services are covered when provided by other health‑care providers; the bill would align reimbursement, prior authorization and coverage frequency to comparable provider types.
- Testimony emphasized this is not about dispensing. Kunke and other witnesses noted prior bills extended pharmacists’ independence to provide certain services (e.g., HIV prophylaxis, contraception, opioid‑use disorder meds) and those laws included Medicaid payment provisions; SB118 would create a broader medical billing pathway for services currently lacking clear codes for Medicaid billing.
- Dr. Zach Roscoe (Idaho State University) was present to address medical billing and model practices from other states.
- DHHS representative Stacy Weeks told the committee no federal waiver would be required to implement the Medicaid billing changes.
Supporters: Nevada Pharmacy Alliance, Nevada Society of Health System Pharmacists, Nevada Primary Care Association, retail and community pharmacists, FQHCs (Nevada Health Centers) and the Retail Association in Nevada provided written or oral support, citing improved patient access, reduced emergency visits and potential cost savings.
Questions and clarifications: Committee members asked about scope, collaborative practice agreements, training, and liability. Testifiers said collaborative practice agreements already authorize diagnosis, ordering labs and prescribing under the delegated arrangement; pharmacists receive clinical training (PharmD curriculum and post‑graduate training) and some pursue advanced practitioner credentials in other states.
Outcome at hearing: The hearing closed after testimony and the bill moved to work‑session consideration.
Ending note: Proponents urged passage to allow Medicaid patients to access pharmacist‑led clinical services and to expand community‑based care options.
