DE SB272

Health insurers, health service corporations, managed care organizations, and health maintenance organizations cannot deny benefits based on provider type as long as the provider acts within their scope of practice, and cannot exclude pharmacists as providers.

Carriers must reimburse pharmacists at rates not less than other nonphysician practitioners for services within the pharmacist's scope of practice that would otherwise be covered if provided by physicians, nurse practitioners, or physician assistants, effective after the bill's passage for individual and group policies.

Licensed pharmacists performing reimbursed services must receive the same rights of participation, plan admission, and registration as other healthcare providers including physicians, nurse practitioners, and physician assistants.

Medicaid coverage is expanded to include pharmacist services provided in various settings including offices, hospitals, skilled nursing facilities, assisted living facilities, pharmacies, and federally qualified health centers.

The Department of Health and Social Services must apply for necessary Medicaid state plan amendments or waivers by December 31, 2024, with the Act taking effect January 1, 2025.