S. 2800: Pharmacy and Medically Underserved Areas Enhancement Act

This bill, known as the Pharmacy and Medically Underserved Areas Enhancement Act, aims to amend the Social Security Act to include coverage for services provided by pharmacists under the Medicare program. Here’s an overview of its key components:

Coverage for Pharmacist Services

The bill specifically updates the definitions in the Social Security Act to include pharmacist services. This is outlined in two main ways:

• The bill states that pharmacist services, as long as they are authorized by state law and performed by licensed pharmacists, may be covered under Medicare.
• These services must be provided in locations identified as health professional shortage areas, medically underserved areas, or to medically underserved populations.

Payment Structure

The legislation outlines how pharmacists will be compensated for their services. Key points include:

• The payment for pharmacist services will be set at 80% of either the actual charge for services or 85% of the standard fee schedule that would apply if a physician had provided the same service.

Implementation Timeline

The amendments regarding coverage and payment will take effect for services provided on or after January 1, 2027, allowing time for the necessary adjustments in the healthcare system.

Pharmacist-Specific Codes

The bill requires the Secretary of Health and Human Services to develop specific codes for pharmacist services, akin to those used for physicians, to facilitate the billing process under the Medicare fee schedule.

Relevant Companies

None found.