Governor says pharmacists should test for COVID-19, but Ohio Medicaid won’t clear the way for them to be paid

By: - June 1, 2020 12:50 am

A researcher works in a COVID-19 lab. (Photo by Kena Betancur/Getty Images).

Ohio Gov. Mike DeWine last week said that he wants to include pharmacists in the coronavirus fight, but he still didn’t offer details on how they’d be paid. Nor did the state department of Medicaid, which has a mechanism to compensate pharmacists to test the population that is most at risk from the virus.

DeWine on Thursday emphasized that Ohio pharmacies need to be places where people can be tested for coronavirus if the state’s testing scheme is to be effective.

“The front-line health care providers are Ohio pharmacists,” he said, adding that they’re trusted community members who “interact in our lives every single day.”

DeWine announced that the Ohio Board of Pharmacy on Wednesday issued guidance clarifying federal instructions on how pharmacies should administer tests because “access to these tests is something that’s vitally important.”

Cameron McNamee, a spokesman for the pharmacy board, said the new guidance makes clear that pharmacists can conduct coronavirus tests without consulting a customer’s doctor.

“There was a little bit of confusion,” he said, adding that the pharmacy board wants to ensure that tests are conducted properly. “We make it very clear that while pharmacists can order these tests, everyone who is doing them has to be appropriately trained.”

The problem, however, is all that costs money and the state has yet to say how that might happen. That’s the case even though Capital Journal first asked how pharmacies might be paid for coronavirus tests in early May.

Ohio’s community pharmacists have for years been complaining that Medicaid reimbursements have been so low that many have been driven out of business and many others have been pushed to the brink.

That’s left many Ohio pharmacists unable to test the population most vulnerable to coronavirus on their own dime, they say.

“They don’t have the financial bandwidth to just donate a bunch of tests to the state,” said Antonio Ciaccia, spokesman for the Ohio Pharmacists Association.

Ciaccia said he’s heard estimates that the tests themselves can cost $30 to $100 each, while staff time and personal protective equipment would add to the cost.

A legal mechanism has existed since January 2019 to give pharmacists “provider status.” 

That way, they can bill Medicaid for services such as coronavirus tests and for other medical services aimed at managing health conditions and keeping folks out of the hospital. But the Ohio Department of Medicaid so far hasn’t implemented the law.

The department didn’t answer questions about the matter in April, when asked about a UnitedHealth plan to pay for such services at two Ohio pharmacies. It also hasn’t hasn’t answered repeated questions since May 15 about when pharmacies can get paid to do coronavirus testing.

Ciaccia said his conversations with DeWine left him with the impression that the governor wants to see Ohio pharmacists paid to test coronavirus patients.

“He gets that they have to be compensated,” Ciaccia said.


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Marty Schladen
Marty Schladen

Marty Schladen has been a reporter for decades, working in Indiana, Texas and other places before returning to his native Ohio to work at The Columbus Dispatch in 2017. He's won state and national journalism awards for investigations into utility regulation, public corruption, the environment, prescription drug spending and other matters.