H.R. 3164: Ensuring Community Access to Pharmacist Services Act
The bill named the Ensuring Community Access to Pharmacist Services Act aims to amend the Social Security Act to include specific pharmacist services under Medicare Part B coverage. Here’s a breakdown of what the bill would accomplish:
Coverage of Pharmacist Services
The bill seeks to formally define and include "pharmacist services" in Medicare, allowing them to be reimbursed. This includes services provided by pharmacists that are authorized under state law, which are similar to those covered when performed by physicians. Specifically, these services may involve:
- Evaluation and management of individuals for COVID-19, influenza, respiratory syncytial virus, and streptococcal pharyngitis.
- Testing or treatment for public health needs during declared health emergencies.
Collaboration Between Pharmacists and Physicians
To provide these services, pharmacists must work in coordination with physicians or other healthcare practitioners per state laws. This collaboration is intended to ensure that pharmacists can deliver care appropriately within their expertise while still receiving the necessary medical direction.
Payment for Pharmacist Services
The bill proposes a specific payment structure for pharmacist services under Medicare. The payments would be set at:
- 80% of either the actual charge for the services or 85% of a preset amount for such services.
- 100% coverage for services related to addressing public health emergencies.
Prohibition on Balance Billing
Additionally, the bill aims to amend existing regulations to prevent "balance billing" for pharmacist services. This means that if a pharmacist provides services covered by Medicare, they cannot charge the patient any additional fees beyond what Medicare reimburses. This protection will also apply to practitioners working with pharmacists.
Implementation Date
The changes proposed would take effect for services rendered on or after January 1, 2026.
Relevant Companies
- CVS - CVS Health Corporation, as a large pharmacy and healthcare provider, may see changes in service offerings and reimbursement models.
- WBA - Walgreens Boots Alliance, being a major pharmacy chain, could be affected by changes in service delivery and partner collab with providers.
This is an AI-generated summary of the bill text. There may be mistakes.
Sponsors
49 bill sponsors
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TrackAdrian Smith
Sponsor
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TrackJake Auchincloss
Co-Sponsor
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TrackMike Bost
Co-Sponsor
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TrackMike Carey
Co-Sponsor
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TrackEarl L. "Buddy" Carter
Co-Sponsor
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TrackJuan Ciscomani
Co-Sponsor
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TrackAngie Craig
Co-Sponsor
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TrackSharice Davids
Co-Sponsor
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TrackSuzan K. DelBene
Co-Sponsor
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TrackLloyd Doggett
Co-Sponsor
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TrackMichelle Fischbach
Co-Sponsor
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TrackBrian K. Fitzpatrick
Co-Sponsor
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TrackVicente Gonzalez
Co-Sponsor
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TrackJosh Gottheimer
Co-Sponsor
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TrackDiana Harshbarger
Co-Sponsor
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TrackKevin Hern
Co-Sponsor
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TrackAshley Hinson
Co-Sponsor
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TrackDusty Johnson
Co-Sponsor
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TrackRobin L. Kelly
Co-Sponsor
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TrackJennifer Kiggans
Co-Sponsor
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TrackYoung Kim
Co-Sponsor
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TrackRaja Krishnamoorthi
Co-Sponsor
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TrackDavid Kustoff
Co-Sponsor
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TrackDarin LaHood
Co-Sponsor
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TrackNicole Malliotakis
Co-Sponsor
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TrackTracey Mann
Co-Sponsor
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TrackDoris O. Matsui
Co-Sponsor
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TrackJennifer L. McClellan
Co-Sponsor
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TrackRichard McCormick
Co-Sponsor
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TrackJohn McGuire
Co-Sponsor
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TrackCarol D. Miller
Co-Sponsor
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TrackJohn R. Moolenaar
Co-Sponsor
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TrackBlake D. Moore
Co-Sponsor
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TrackNathaniel Moran
Co-Sponsor
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TrackEleanor Holmes Norton
Co-Sponsor
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TrackBurgess Owens
Co-Sponsor
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TrackEmily Randall
Co-Sponsor
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TrackBradley Scott Schneider
Co-Sponsor
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TrackTerri A. Sewell
Co-Sponsor
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TrackDarren Soto
Co-Sponsor
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TrackW. Gregory Steube
Co-Sponsor
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TrackClaudia Tenney
Co-Sponsor
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TrackPaul Tonko
Co-Sponsor
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TrackLori Trahan
Co-Sponsor
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TrackDerek Tran
Co-Sponsor
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TrackBeth Van Duyne
Co-Sponsor
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TrackMarc A. Veasey
Co-Sponsor
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TrackEugene Vindman
Co-Sponsor
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TrackRudy Yakym III
Co-Sponsor
Actions
2 actions
| Date | Action |
|---|---|
| May. 01, 2025 | Introduced in House |
| May. 01, 2025 | 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. |
