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Comments needed on Ohio Medicaid's proposed provider status rules

On June 29, the Ohio Department of Medicaid released their long-anticipated draft pharmacist provider status rule proposals. The rules are the next necessary steps in OPA's push to expand patient access to pharmacist-provided clinical services.

As we have chronicled, at the beginning of 2019, in one of his final acts as governor of Ohio, John Kasich signed Senator Matt Dolan's SB 265, which formally recognized pharmacists as "providers" in Ohio law, which changed key provider definitions and insurance laws to catch up to the growing and evolving role of the pharmacist. SB 265 removed barriers that have prevented health plans, hospitals, and healthcare teams from integrating and utilizing the expertise of the pharmacist to expand access to care and improve patient outcomes.

After 18 months of discussions with lawmakers and the Department on implementing the law, the draft rule changes have officially been posted for review and comments.

To view the proposed rule changes, CLICK HERE.

Any questions and comments in regards to the rule should be sent to by Friday, July 10.

Please send your comments to Antonio Ciaccia at as well so that we can ensure member feedback is considered in OPA's organizational letter.

We appreciate the Department for putting this draft together so that stakeholders can review and provide feedback on the rules.

Our initial read of the rules is that even though pharmacists can offer a broad range of services within their scope of practice, payment for pharmacist services will only be permitted for services rendered on behalf of a physician. If you have any issues with the rules, it is important that you submit your comments this week.

For background on OPA's provider status efforts, CLICK HERE.

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