Us Congress 2023-2024 Regular Session

Us Congress Senate Bill SB2405

Introduced
7/20/23  

Caption

Strengthening Pharmacy Access for Seniors Act

Impact

The implications of SB2405 are significant for Medicare recipients, as it seeks to improve their access to necessary medications across a wider range of pharmacies. By requiring PDP sponsors to provide transparency about their access limitations and the rationale behind them, the bill aims to empower beneficiaries and ensure they have more options for obtaining prescription drugs. This initiative is particularly crucial for seniors who rely heavily on medications and often struggle with access issues due to restrictive pharmacy networks.

Summary

Senate Bill 2405, titled the 'Strengthening Pharmacy Access for Seniors Act', aims to amend Title XVIII of the Social Security Act to enhance pharmacy access and choice for Medicare beneficiaries. The legislation establishes guidelines that limit the ability of prescription drug plan (PDP) sponsors and pharmacy benefit managers to restrict access to certain medications by designating them as 'limited access drugs'. Beginning in plan year 2026, any restrictions on access to covered Part D drugs must be justified in writing, and this justification must be maintained for review.

Conclusion

Overall, SB2405 represents a proactive step towards enhancing pharmacy access for Medicare beneficiaries, aiming to address long-standing issues regarding medication accessibility. However, as with many pieces of legislation, the success of this bill will depend on its practical execution and the buy-in from all stakeholders involved in the healthcare system.

Contention

Debates around SB2405 may center on how effectively it will balance the interests of the insurance companies, pharmacy benefit managers, and the needs of Medicare beneficiaries. Advocates are likely to emphasize the bill's potential to increase competitive practices among pharmacies, while critics may raise concerns about the administrative burden placed on pharmacy benefit managers and the potential impact on their pricing strategies. Ensuring compliance and handling exceptions could also introduce complications in the implementation of this bill, raising questions about its overall feasibility.

Companion Bills

No companion bills found.

Previously Filed As

US SB2052

Protect Patient Access to Pharmacies Act

US SB2129

Ensuring Access to Lower-Cost Medicines for Seniors Act

US HB5393

To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.

US SB2254

Medicare PBM Accountability Act

US HB3561

PATIENT Act of 2023 Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023

US SB1339

Pharmacy Benefit Manager Reform Act

US SB127

Pharmacy Benefit Manager Transparency Act of 2023

US HB5378

Lower Costs, More Transparency Act

US HB4883

Medicare Common Ownership Transparency Act of 2023

US HB5150

To direct the Secretary of Defense to submit to Congress a report evaluating beneficiary access to TRICARE network pharmacies.

Similar Bills

CA AB913

Pharmacy benefit managers.

CA SB362

Chain community pharmacies: quotas.

LA HB432

Provides for the regulation of pharmacy services administrative organizations (OR +$88,000 SG EX See Note)

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

LA HB387

Provides for the regulation of pharmacy services administrative organizations

CA AB401

Pharmacy: remote dispensing site pharmacy: telepharmacy: shared clinic office space.

CA AB690

Pharmacies: relocation: remote dispensing site pharmacy: pharmacy technician: qualifications.

AR SB593

To Amend The Arkansas Pharmacy Benefits Manager Licensure Act; And To Create The Pharmacy Services Administrative Organization Act.