NJ A3591

NJ FamilyCare (Medicaid) would be required to reimburse licensed clinical pharmacists for comprehensive medication management services provided to medically complex pediatric patients enrolled in the program.

Covered services include comprehensive reviews of all medications (prescription, over-the-counter, vitamins, and supplements), development of patient-specific medication action plans, ongoing monitoring, and follow-up consultations.

Licensed clinical pharmacists providing these services must complete a clinical residency or Board of Pharmacy Specialties certification and meet additional credentialing requirements established by the Division of Medical Assistance and Health Services and the Board of Pharmacy.

Pharmacists meeting these requirements would not need to enter into a written agreement with a licensed physician to provide these medication management services to medically complex pediatric patients.

The Division must enter into value-based reimbursement contracts with pharmacists for these services and establish a quality assurance program to monitor outcomes and evaluate efficacy.