AB-2571 Reimbursement for pharmacist services
Sep 6, 2026 edition · GC-2026-0079 · Published 2026-09-06 · Version 2 · Proposed
Pending AB 2571 would expand pharmacist payment routes and advanced-practitioner reimbursement, with distinct commercial, Medi-Cal and FQHC/RHC conditions.
What happened
AB 2571 would add pharmacists enrolled as providers with a plan or insurer to specified payment routes and use a similar-services test, while preserving lawful scope of practice and protection against duplicate payment. Pharmacists in FQHCs and rural health clinics are included in that definition. The commercial-plan provision excludes Medi-Cal managed care, which is addressed under separate Medi-Cal sections. At the cutoff this is a proposal, not an established right to payment for every pharmacist service or every setting.
The proposed Medi-Cal changes set advanced pharmacist practitioner reimbursement at no less than eighty-five percent of physician-fee-schedule rates, including medication therapy management. FQHC/RHC provider recognition requires a state-plan amendment, other necessary federal approvals, federal participation and an appropriation. Medication therapy management retains contracts, covered specialty-drug categories, utilization protocols and funding conditions. Those distinct routes require attention to practitioner status, enrollment, scope, contract and the particular service; a headline percentage does not replace the conditions for an eligible claim.
Scope and timing
- Authority status
- Proposed
- Applicability
- Potentially applicable
- Audience
- Health systems, Provider networks
- Jurisdiction
- California
- Affected functions
- Managed Care, Revenue Cycle, Finance, Provider Enrollment, Compliance
- Responsible owner
- Managed Care
Why it matters
Commercial network rules, Medi-Cal fee-schedule rules and FQHC/RHC reimbursement do not operate as one interchangeable payment entitlement.
Recommended action
Map pharmacist credentials, enrollment and service arrangements by payer and setting. Assess proposed contracting and reimbursement changes, then monitor enactment, federal approval, funding and DHCS instructions before changing claims.
Sources
- AB2571 proposed bill text, historical selected versionOfficial · California Legislature · 2026-09-01 · Source review 2026-10-15
- AB2571 official bill historyOfficial · California Legislature · Source review 2026-10-15
Complete edition and supplemental material
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