Preserving Patient Access to Long-Term Care Pharmacies Act

Key Points

• This bill would require Medicare drug plans to pay a $30 "supply fee" to pharmacies that serve long-term care facilities, like nursing homes. This extra payment helps these specialized pharmacies cover the costs of delivering and managing medications for seniors with complex health needs.
• The new fees would be required for two years, starting in 2026. In 2027, the $30 amount would increase slightly to account for inflation. If an insurance company refuses to pay the fee to a pharmacy, the government can fine them at least $10,000 for every prescription they missed.
• The federal government will eventually pay the insurance companies back for these fees. This is designed to support pharmacies without forcing insurance companies to raise monthly premiums for people on Medicare.
• This plan focuses on drugs that have had their prices negotiated by the government. Because these drugs are cheaper, pharmacies make less profit on them. This fee is meant to make up the difference so these pharmacies can afford to stay in business and continue serving vulnerable patients.
• The bill also orders a non-partisan government study to look at whether long-term care pharmacies are being paid enough to stay in business long-term. This is especially important for people living in rural areas where there may only be one pharmacy available to serve local nursing homes.

Impact Analysis

Govbase has not yet run an impact analysis on this legislation.