Equitable Community Access to Pharmacist Services Act | ChamberLight
Bills · S 2426
IN COMMITTEE· 119TH CONGRESS
Senate BillS 2426MedicareHealth care coverage and access
Equitable Community Access to Pharmacist Services Act
INTRO JUL 24· LAST ACTION JUL 24
READING
3MIN
COSPONSORS
31BIPARTISAN
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8
Introduced
In Committee
Reported
Passed Senate
Passed House
Conference
To President
Became Law
WHAT THE BILL DOES
AI-written
This bill matters because it could significantly improve access to common healthcare services, especially for older Americans and those in underserved areas. If it becomes law, people with Medicare Part B would have more options for getting tested and treated for everyday illnesses like the flu or strep throat, or for future public health crises, potentially without needing to wait for a doctor's appointment or visit an emergency room.
Without this bill, Medicare beneficiaries would continue to rely primarily on doctors' offices or urgent care centers for these services to be covered, which can be less convenient or accessible. The bill could also strengthen the role of pharmacists in community health, making healthcare more efficient and responsive to local needs. It could free up doctors to focus on more complex cases while still ensuring people get timely care for common conditions.
KEY PROVISIONS
5AI-extracted
PROVISION 01
Medicare Part B would cover certain services provided by pharmacists, defining these as 'pharmacist services.'
This expands the range of healthcare providers Medicare will pay for, increasing access to care for beneficiaries.
PROVISION 02
The covered pharmacist services include testing and treatment for COVID-19, influenza, RSV, streptococcal pharyngitis (strep throat), and services addressing public health emergencies.
This targets common, impactful illnesses and critical public health needs, making it easier for people to get quick care.
PROVISION 03
For services where state law requires it, pharmacists must perform these services under the supervision of or in collaboration with a physician.
This ensures that pharmacist services remain within established legal and professional boundaries defined by each state.
PROVISION 04
Medicare would pay 80% of the approved amount for most pharmacist services, but 100% for services addressing a public health emergency.
This establishes the reimbursement structure for pharmacists and provides full coverage for critical public health efforts.
PROVISION 05
Pharmacists would be prohibited from 'balance billing' Medicare beneficiaries for these covered services, meaning they cannot charge patients above the Medicare-approved amount.
This protects Medicare patients from unexpected costs and ensures affordability of these new services.
This bill matters because it could significantly improve access to common healthcare services, especially for older Americans and those in underserved areas. If it becomes law, people with Medicare Part B would have more options for getting tested and treated for everyday illnesses like the flu or strep throat, or for future public health crises, potentially without needing to wait for a doctor's appointment or visit an emergency room.
Without this bill, Medicare beneficiaries would continue to rely primarily on doctors' offices or urgent care centers for these services to be covered, which can be less convenient or accessible. The bill could also strengthen the role of pharmacists in community health, making healthcare more efficient and responsive to local needs. It could free up doctors to focus on more complex cases while still ensuring people get timely care for common conditions.
KEY PROVISIONS
AI-extracted
high
Medicare Part B would cover certain services provided by pharmacists, defining these as 'pharmacist services.'
This expands the range of healthcare providers Medicare will pay for, increasing access to care for beneficiaries.
high
The covered pharmacist services include testing and treatment for COVID-19, influenza, RSV, streptococcal pharyngitis (strep throat), and services addressing public health emergencies.
This targets common, impactful illnesses and critical public health needs, making it easier for people to get quick care.
med
For services where state law requires it, pharmacists must perform these services under the supervision of or in collaboration with a physician.
This ensures that pharmacist services remain within established legal and professional boundaries defined by each state.
med
Medicare would pay 80% of the approved amount for most pharmacist services, but 100% for services addressing a public health emergency.
This establishes the reimbursement structure for pharmacists and provides full coverage for critical public health efforts.
high
Pharmacists would be prohibited from 'balance billing' Medicare beneficiaries for these covered services, meaning they cannot charge patients above the Medicare-approved amount.
This protects Medicare patients from unexpected costs and ensures affordability of these new services.
The amendments made by this section shall apply to items and services furnished on or after this date.
GLOSSARY
AI-written
Medicare Part B
A part of Medicare that covers medically necessary services like doctor's visits, outpatient care, durable medical equipment, and some preventive services.
Pharmacist Services
Specific health services provided by a pharmacist, such as testing and treatment for certain illnesses, that are legally allowed under state law.
Social Security Act
The main law that established Social Security and Medicare programs in the United States, providing for various forms of social welfare.
Public Health Emergency
A situation officially declared by the Secretary of Health and Human Services due to a disease or other health threat that poses a significant risk to the health and security of the U.S. population.
Balance Billing
When a healthcare provider charges a patient for the difference between the provider's usual fee and the amount Medicare (or another insurer) approves and pays.
Collaboration
A process where a pharmacist works with a doctor to deliver healthcare services within the pharmacist's expertise, following medical direction and supervision as defined by state law or joint guidelines.
Respiratory Syncytial Virus (RSV)
ACTION TIMELINE
2 EVENTS
JUL 24, 25
Introduced in Senate
INTROREFERRAL
JUL 24, 25
Read twice and referred to the Committee on Finance. (text: CR S4701)
