Ray Love, PharmD, BCPP, FASHP
Member at Large and Incoming President-Elect, CPNP Board of Directors
The CPNP Strategic Plan makes a commitment to current and future neuropsychiatric pharmacists under the heading Our Profession. The goal is the inclusion of neuropsychiatric pharmacists on health care teams, which requires us to look at the distant future of health care. Over the past few years, we have devoted considerable time and energy to Governmental Affairs (GA) in order to play an active role in defining the future of our profession. Given issues like opioid misuse and overuse, excessive use of psychotropic medications in the young, elderly and vulnerable and the Affordable Care Act, GA has become an increasingly important focus for members and our organization.
In recent years, CPNP has participated with other pharmacy organizations in deliberations regarding the best path to obtain pharmacist reimbursement under Medicare Part B. While the profession-wide discussions continued, the CPNP Board voted to collaborate with the American College of Clinical Pharmacy (ACCP) more than a year ago to seek to establish Comprehensive Medication Management (CMM) as a service provided by pharmacists and reimbursable under Medicare Part B. This collaboration pre-dated the recent Patient Access to Pharmacists’ Care Coalition (PAPCC). CPNP chose to collaborate with ACCP, because ACCP recognized the needs of individuals with neurologic and psychiatric disorders and committed to a proposal that included them. They also focused on reimbursement for a specific service that could be furnished by neuropsychiatric (and other) pharmacists rather than seeking Medicare reimbursement for all pharmacist provided services. This is important because the cost for Medicare to pay for every pharmacist service would be astronomical and would be unlikely to pass Congress. Finally, CPNP agreed that CMM was a logical and viable practice model for a large number of our members and noted that it was accepted by other health professions, most notably physicians. In order to help obtain Medicare reimbursement for CPNP members, the strategic plan commits to continuation of the CPNP effort to obtain payment for CMM.
Another opportunity for neuropsychiatric pharmacists is substance abuse and addiction. It seems that every day brings a new headline about opioid abuse and overdose. Yet pharmacists are often left out of this discussion. More importantly, the position of neuropsychiatric pharmacists is rarely considered. Even pharmacists practicing under collaborative practice protocols cannot prescribe buprenorphine for the management of opioid addiction because of federal prohibitions restricting its use to physicians. How can a psychiatric pharmacist provide comprehensive behavioral health care when they are prohibited from managing this medication?
Recognizing the comorbid nature of substance abuse and psychiatric disorders, CPNP has made a commitment to define and establish the role of neuropsychiatric pharmacists in substance abuse. In particular, a task force has been established to address the role of the pharmacist in buprenorphine treatment and naloxone rescue education. This will not be an easy goal to achieve. CPNP will need to recruit partners for this effort, enter into new alliances, and establish educational programs to support these efforts. We are embarking on this journey because it is the right thing to do for the patients whom we serve, and it will yield new opportunities for our members, future neuropsychiatric pharmacists and CPNP.
CPNP participates in regular meetings of the governmental affairs staff of a number of pharmacy organizations including the American Society of Health-Systems Pharmacists, American Pharmacists Association, American College of Clinical Pharmacy, Academy of Managed Care Pharmacy, American Society of Consultant Pharmacists and others. This is called the Pharmacy Stakeholders group. Within this group, CPNP notes that the organization continues to support the efforts of PAPCC even though we have not been permitted to join given our commitment to the ACCP – CPNP CMM Initiative. These meetings inform CPNP of the progress of PAPCC and provide information regarding new bills, regulations and initiatives affecting neuropsychiatric pharmacy. It also gives CPNP an opportunity to participate in commenting on these individually as an organization or as part of a multi-organizational response. CPNP has committed to continued participation in these efforts so that we can be an active participant in defining our future.