Rx ACCESS Act
Sponsored By: Representative Kiggans (VA)
Introduced
Summary
Would expand beneficiary choice and require fairer pay for TRICARE retail pharmacies. This bill would let eligible TRICARE beneficiaries choose how to receive non-generic maintenance prescriptions and set new payment and audit rules for the TRICARE pharmacy program.
Show full summary
- Beneficiaries: Eligible covered beneficiaries would be able to elect to receive non-generic prescription maintenance medications through any means described in paragraph (2)(E) beginning October 1, 2026.
- Retail pharmacies: Reimbursement to TRICARE retail pharmacies would have to cover either the pharmacy's actual wholesale acquisition cost or a national average acquisition cost proxy and include a professional dispensing fee equal to the State's Medicaid dispensing fee.
- Contractors and PBMs: Contractors administering the TRICARE pharmacy benefits program could not impose point-of-sale fees, retroactive fees, or other indirect or hidden fees on TRICARE retail pharmacies.
- Oversight and access: The Comptroller General would conduct annual audits of reimbursement rates, price concessions, and the adequacy of the retail pharmacy network, including continuity of care and geographic access with special attention to rural and underserved areas.
- Implementation: The Secretary of Defense would be required to submit an implementation plan to the congressional defense committees within 90 days of enactment and must ensure contractors provide information for audits.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
More choice for TRICARE refills
If enacted, eligible TRICARE beneficiaries would be able to choose how to get non‑generic maintenance prescriptions. This choice would begin on October 1, 2026. One option would be getting these meds at TRICARE retail pharmacies.
Better pay and no hidden fees for TRICARE pharmacies
If enacted, TRICARE retail pharmacies would have a minimum reimbursement rule. Payments would cover the pharmacy's acquisition cost or a NADAC proxy and add a State Medicaid dispensing fee. The bill would also bar contractors from charging point‑of‑sale, retroactive, or hidden fees to those pharmacies.
Annual audits of TRICARE pharmacy program
If enacted, the Comptroller General would audit TRICARE pharmacy contractor data at least annually. Audits must check reimbursement rates, price concessions, and retail network access, including rural and underserved areas. The contractor would have to give GAO the needed information and results go to congressional Armed Services committees.
Sponsors & CoSponsors
Sponsor
Kiggans (VA)
VA • R
Cosponsors
Goodlander
NH • D
Sponsored 12/3/2025
Luttrell
TX • R
Sponsored 12/3/2025
Houlahan
PA • D
Sponsored 12/3/2025
Mills
FL • R
Sponsored 3/18/2026
Roll Call Votes
No roll call votes available for this bill.
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