Pharmacists push into maternal care
An industry article argues pharmacists should receive training and legislative support to close maternal‑health service gaps, including screening for depression, intimate‑partner violence and substance use, and getting paid for cognitive services. The piece highlights fragmented state scopes of practice and calls for payment reform to let pharmacists work at the top of their license in perinatal care. (drugtopics.com)
Pharmacists are pressing to take a bigger role in pregnancy and postpartum care, arguing state laws and payment rules still block routine maternal-health services in pharmacies. (drugtopics.com) The push comes as the United States maternal mortality rate remained far higher for Black women in 2023: 50.3 deaths per 100,000 live births, versus 14.5 for White women and 12.4 for Hispanic women, according to the Centers for Disease Control and Prevention. (cdc.gov) In the pharmacy debate, the proposed work is mostly “cognitive” care: screening, counseling, referral and medication follow-up rather than labor-and-delivery medicine. The article says pharmacists could help screen for perinatal depression, intimate-partner violence and substance use if they get training and legal authority. (drugtopics.com) Those screenings already sit inside standard maternal care. The American College of Obstetricians and Gynecologists recommends depression and anxiety screening at the initial prenatal visit, later in pregnancy and at postpartum visits using validated tools. (acog.org) The same medical group says substance use in pregnancy should be handled as a health issue tied to treatment and continued care, not punitive testing, and it backs Medicaid coverage for substance-use and mental-health services for a full year after delivery. (acog.org) The bottleneck is that pharmacists’ scope of practice is set state by state. The National Academy for State Health Policy says states use different tools — statewide protocols, standing orders and collaborative practice agreements — to decide what pharmacists can prescribe or manage. (nashp.org) Payment is just as uneven. The National Alliance of State Pharmacy Associations said 165 bills on pharmacist scope and payment were introduced in 41 states in 2024, and 45 bills in 31 states were enacted. (naspa.us) Some states already pay pharmacists for professional services through Medicaid. Maryland says Medicaid-enrolled pharmacists can bill for medication therapy management, contraceptive prescribing, smoking-cessation prescribing and vaccinations, while Pennsylvania began enrolling pharmacists as mid-level practitioners in March 2024 for covered services in scope. (health.maryland.gov) (pa.gov) Maternal-care advocates have also spent the past three years widening postpartum insurance coverage. The National Academy for State Health Policy says the American Rescue Plan Act of 2021 let states extend Medicaid postpartum coverage from 60 days to 12 months, and Congress made that option permanent in the Consolidated Appropriations Act of 2023. (nashp.org) That leaves the practical question raised by the pharmacy article: whether states and insurers will pay pharmacists for screenings, counseling and referral work that obstetric guidelines already treat as part of routine perinatal care. (drugtopics.com) (acog.org)
