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Congress·In Committee·H.R. 3164

Rep. Smith Introduces Bipartisan Bill to Pay Pharmacists for Testing and Treating Flu, COVID, and Strep

Ensuring Community Access to Pharmacist Services Act

11 months ago·View on Congress.gov·Read full text

Legislative Progress

House
Senate
President
Law

Key Points

  • This bill would add pharmacist services as a covered benefit under Medicare Part B, allowing pharmacists to be directly reimbursed for testing and treating patients with COVID-19, influenza, RSV, and strep throat.
  • Pharmacists could only bill Medicare for these services if their state already allows them to perform such tasks. In states requiring physician collaboration, pharmacists must follow those rules.
  • Medicare would pay 80% of 85% of the physician fee schedule rate for routine pharmacist services, but 80% of 100% of that rate during a declared public health emergency.

    From policy text

    “the amounts paid shall be equal to 80 percent of the lesser of (i) the actual charge for the services or (ii) 85 percent (or 100 percent, in the case of such services that address a public health need described in paragraph (2)(B) of such section) of the amount determined under the payment basis under section 1848 for such services”
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  • The bill prohibits pharmacists from balance billing Medicare patients, meaning seniors won't face surprise charges above the Medicare-approved amount.

    From policy text

    “subparagraph (A), by inserting ``or a pharmacist'' after ``a practitioner described in subparagraph (C)''”
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  • If enacted, the new coverage would take effect for services provided on or after January 1, 2026, giving pharmacies and Medicare time to prepare.

    From policy text

    “The amendments made by this section shall apply to items and services furnished on or after January 1, 2026.”
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Healthcare

Impact Analysis

Personal Impact

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions
May 1, 2025House

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

May 1, 2025

Introduced in House

Related Bills

1 bill
S. 2426Related bill

Equitable Community Access to Pharmacist Services Act

Jul 24 — Read twice and referred to the Committee on Finance.

Source Information

Document Type

Congressional Bill

Official Title

Ensuring Community Access to Pharmacist Services Act

Bill NumberHR 3164
Congress119th Congress
ChamberHouse of Representatives
Latest ActionReferred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Read Full Bill Text

Sponsor

Cosponsors

(101)
D: 49R: 52

Analysis generated by AI. Always verify with official sources.