Medicine’s objections were strong, and the state’s draft rules allowing pharmacists to perform medication therapy management (MTM) services aren’t going to make it after all.
The Texas State Board of Pharmacy (TSBP) in January proposed the rules, which the Texas Medical Association said would improperly broaden pharmacists’ scope of practice, among other criticisms. TSBP heeded TMA’s warnings and announced that it withdrew the proposal this week.
TMA argued in its comments that the rules weren’t based on state law because state law contains no guidance for MTM services. TMA also said the language in TSBP’s proposal was “broad and vague,” and that the rules “authorize pharmacists to perform services that exceed the scope of pharmacy.”
“The proposed rules essentially define MTM services to be ‘pharmaceutical care services . . . provided by a pharmacist to optimize therapeutic outcomes for individual patients,’” TMA said. “What follows that broad statement is a non-exhaustive list of services that a pharmacist might provide as MTM services.”
For example, TMA noted, that list included authorizing a pharmacist to “perform a comprehensive medication therapy review at each patient encounter.”
“Whether a medication therapy review is necessary should be a decision made in conjunction with the patient’s physician,” TMA said in its comments.
TMA’s letter ultimately recommended that TSBP pull down the rule “pending statutory direction from the legislature or, in the alternative, until the rules may be properly vetted with appropriate stakeholders.” TSBP announced in the March 8 edition of the Texas Register that it had pulled the proposal.
Alison Benz, executive director for TSBP, told Texas Medicine Today on Wednesday that she believes TMA’s remarks about scope-of-practice expansion played into the board’s decision.
“That’s not what they were trying to do. But because there were those concerns brought up in the letter that the board received, they didn’t want to cause anyone to be concerned,” Ms. Benz said. “They may at some point in the future do something again [with] that rule. But those comments did, I think, raise issues, and they just didn’t want to have any problem with that.”