The Colorado General Assembly conducts periodic "sunset reviews" of the rules governing specific state boards, agencies, or functions of government. If changes are deemed necessary to these rules, revisions may be made through new legislation. In 2021, the laws, rules, and policies governing the Colorado State Board of Pharmacy were due for such a review. Led by the Colorado Pharmacists Society and the sponsorship of Colorado state senators Faith Winter and Joann Ginal and Representatives Dylan Roberts and David Ortiz, Senate Bill 94 was signed into law June 24, 2021 by Colorado Governor Jared Polis, greatly expanding the scope of practice for state pharmacy professionals.
The expansion of collaborative practice agreements under the new legislation can enhance oncology patient care in several key ways, according to Stephanie Evangelisti, PharmD, MS, BCOP, the pharmacy director of Grand Valley Oncology and a member-at-large of the Rocky Mountain Oncology Society. "This legislation is expanding the scope of practice for both pharmacists and pharmacy technicians," she affirms. “Collaborative practice agreements are becoming more adaptable for us as we work toward achieving provider status.”
Dr. Evangelisti says the revised rules expand the scope of practice for pharmacists by giving them authority to adjust patient prescriptions in terms of dosage and quantity, supply missing information, and make limited substitutions in the same class of therapeutic agents. This expanded authority can decrease lengthy wait times for patients. “We're also looking at giving pharmacists the ability to prescribe certain drugs for specified conditions, order laboratory tests, and do limited physical assessments, all under collaborative practice agreements,” says Dr. Evangelisti.
She adds that enabling pharmacists to work to the top of their license increases their visibility in the medical profession: “It seems we've always been the 'hidden profession,’ so it's great to see state legislation help push us to the forefront of patient care services. It's an incredible step forward for the profession as we try to work toward provider status.”
Obtaining provider status would enable pharmacists to bill for their services under Medicare Part B. “Due to the COVID-19 backlog of patients needing preventive care screening and entering the system with more advanced disease, it’s more important than ever for pharmacists to be collaborative members of the multidisciplinary care team,” says Dr. Evangelisti. “Expanded scope of practice will help pharmacy become a more patient-focused profession, teaching people what a given medication does and what to expect from it, hopefully improving adherence and overall patient outcomes.”
While Colorado’s collaborative practice expansion is an enormous step forward on the state level, pharmacists hope that the new bill will prompt the Centers for Medicare & Medicaid Services to cover medication therapy management service under Part B in addition to Part D: “That's where we're going to see the biggest impact on cancer care centers,” says Dr. Evangelisti. “Since most of us are Part B institutions, we will hopefully be considered independent licensed providers (physician extenders), which will bring in the revenue to justify the positions that are so sorely needed."
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