California Pharmacists to Order Tests, but Will Laboratories Get Paid?

‘Advanced Practice Pharmacists’ will be able to order and interpret laboratory tests effective January 1

A NEW LAW IN CALIFORNIA allows pharmacists to order laboratory tests for monitoring patients’ medications. But it is unclear if labs will be paid for such tests under the law.

California Governor Jerry Brown signed the bill, SB 493, into law on October 1. It raises the status of pharmacists as healthcare providers and widens their scope of practice, according to an article in Modern Healthcare.

The Pharmacy Law authorizes the California State Board of Pharmacy to recognize an “advanced practice pharmacist” who can “order and interpret tests for the purpose of monitoring and managing the efficacy and toxicity of drug therapies…” The law also allows advanced-practice pharmacists to perform patient assessments.

“Regarding payment, the bill does not address payment for the ordering or interpreting of lab tests, nor for the coverage of lab tests ordered by pharmacists,” Brian Warren wrote in an email. Warren is the Vice President, Center for Advocacy, for the California Pharmacists Association.

“It will be up to individual payers to determine whether or not to pay for tests ordered by pharmacists, and until they are covered, you probably won’t see many pharmacists ordering tests,” stated Warren. “This is all designed to complement the medication adherence and other clinical services that pharmacists are increasingly providing to patients. As payers contract with pharmacies to manage patients, we envision that these tests will be necessary and will be covered.

“Pharmacists in California have been able to order lab tests for several years, though it was generally restricted to pharmacists working in hospitals and integrated systems such as Kaiser Permanente,” continued Warren. “In a number of states, including North Carolina and New Mexico, pharmacists can order lab tests. Additionally, pharmacists order lab tests throughout the country through the care they provide in the Indian Health Service, Veterans Administration, and other federal health programs.”

Reimbursement Is Uncertain

Blue Shield of California (BSC) supports the law, according to spokesman Sean Barry, but BSC was unable to confirm if it would pay for lab tests ordered by pharmacists. The state Department of Health Care Services, which runs the Medi-Cal program, said labs would not be paid under the law.

The willingness of the California state legislature to widen the scope of practice for pharmacists and allow them to order and interpret lab tests is one more marketplace indicator of the changes unfolding across the American healthcare system.

For pathologists and clinical lab managers, this change in California raises an interesting question. Will the new phar- macy law create a new type of customer for clinical laboratories?


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