To amend title XVIII of the Social Security Act to assure pharmacy access and choice for medicare beneficiaries.
Impact
If enacted, HB 7718 is expected to significantly alter the landscape of Medicare pharmacy benefits by establishing more inclusive participation requirements for pharmacies. This legislative measure could help dismantle existing barriers that limit beneficiary access to necessary medications, especially in areas with fewer pharmacy options. The bill establishes a framework for the Secretary of Health and Human Services to set future standards for contract terms, ensuring they remain reasonable and relevant to current market conditions.
Summary
House Bill 7718 aims to amend Title XVIII of the Social Security Act to enhance pharmacy access and choice for Medicare beneficiaries. The bill mandates that any pharmacy meeting the standard contract terms be allowed to participate as a network pharmacy in prescription drug plans. This change is intended to broaden the options available to beneficiaries, ensuring they can choose from a wider array of pharmacies, which may lead to increased convenience and potentially reduced costs for these individuals.
Contention
While the bill seeks to improve pharmacy access, there may be potential contention regarding the implications for existing pharmacy networks and the financial viability of smaller pharmacies. Some stakeholders have expressed concerns that requiring all willing pharmacies to participate may lead to unintended consequences, such as reduced bargaining power for pharmacies and impacts on reimbursement models. The effective implementation of this bill will likely spark debates among pharmaceutical providers, insurers, and government agencies on how to balance access with the sustainability of pharmacy operations.
To amend title XVIII of the Social Security Act to provide for enforcement of standards for reasonable and relevant contract terms and conditions and essential retail pharmacy protections under the Medicare program.
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.
To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes.
To amend title XVIII of the Social Security Act to provide for the guaranteed issue of Medigap policies to all Medigap-eligible Medicare beneficiaries and Medicare Advantage enrollees, and for other purposes.