Provider Status

Disease Management

Policy 9907
 

11/01/1999 Introduced
03/01/2004 Reapproved
12/01/2008 Revised
10/01/2012 Revised
02/21/2018 Revised

AMCP supports disease management as the concept of reducing health care costs, closing gaps in care, and improving quality of life for individuals with chronic conditions by preventing or minimizing the effects of the disease through integrated medical and pharmacy management. Disease management programs are designed to improve health outcomes and reduce associated costs from avoidable complications and medication adverse events by identifying and treating chronic conditions more quickly and effectively, and improving appropriate medication use and adherence, thus slowing the progression of those diseases.  AMCP recognizes that, as a trained medication management specialist, the pharmacist has clinical expertise and a leadership role to play in the collaborative development, implementation and improvement of disease management programs.

(See AMCP Concepts in Managed Care Pharmacy – Disease Management)

Pharmacy CPT Codes

Policy 0022

02/01/2000 Introduced
02/01/2005 Reapproved
11/01/2009 Reapproved
02/01/2014 Reapproved
04/29/2020 Revised
AMCP supports the use and expansion of pharmacy-specific codes listed in the American Medical Association's Physicians' Current Procedural Terminology (CPT) coding structure to assist pharmacists in documenting professional services as health care providers.

Pharmacy Benefits for the Uninsured/Underinsured

Policy 0118

11/01/2001 Introduced
02/01/2006 Revised
12/01/2010 Reapproved
03/25/2019 Revised
10/16/2023 Revised

 

AMCP supports the equitable access to medications and the development of integrated systems that optimize public and private programs such as 340B, Patient Assistance Programs (PAP) and charitable medication distributors to ensure access to enhanced pharmacy services and pharmaceutical products for all patients, regardless of insurance coverage or income. In addition, AMCP encourages innovations that provide affordable medication access such as comparing a PBM's network price, access to discounted drug retailers and point of care eligibility for PAP.

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