Preserving Patient Access to Long-Term Care Pharmacies Act
Impact
The enactment of HB 5031 would affect the payment mechanisms underlying long-term care pharmacies, which play a crucial role in providing medications to patients in nursing homes and similar facilities. By establishing a dedicated supply fee, the bill is intended to ensure that these pharmacies can sustain their operations amidst the complexities of Medicare reimbursement. Furthermore, it emphasizes the importance of supporting pharmacies that cater to vulnerable populations, thus enhancing patient access to necessary medications.
Summary
House Bill 5031, titled the 'Preserving Patient Access to Long-Term Care Pharmacies Act,' aims to amend the Social Security Act to temporarily provide for long-term care pharmacy supply fees associated with the dispensing of specific drugs. This bill introduces a new reimbursement structure for long-term care pharmacies, ensuring that these pharmacies receive direct fees when they dispense medications to enrollees in Medicare prescription drug plans. The proposed fees are set at $30 for the year 2026, with an increment for the year 2027 based on defined annual percentage increases.
Contention
While the bill aims to improve reimbursement structures for long-term care pharmacies, there may be contention surrounding the potential economic impacts on the broader healthcare landscape. Some stakeholders might argue that additional fees could strain the Medicare system if not properly managed or justified. Additionally, there could be concerns about how these changes might affect competition among pharmacies and the availability of medications for patients in rural areas, which have historically faced challenges in accessing pharmacy services. Legislators and lobbyists may actively debate these issues as the bill progresses through committee discussions.
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.
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.