S2426119th CongressWALLET

Equitable Community Access to Pharmacist Services Act

Sponsored By: Senator John Thune

Introduced

Summary

Medicare Part B coverage for pharmacist services. This bill creates a new Part B benefit so pharmacists can provide and bill Medicare for certain evaluation, testing, and treatment services while setting payment rules and banning balance billing.

Show full summary
  • Seniors and people on Medicare get easier access to pharmacist-delivered care for testing and treatment of COVID-19, influenza, RSV, streptococcal pharyngitis, and other declared public health needs, with protections against balance billing and services effective January 1, 2026.
  • Pharmacists can bill Medicare when working under required state-law supervision or collaboration and under jointly developed guidelines. Payments are generally 80% of the lesser of the actual charge or 85% of the physician payment amount.
  • Public health response is strengthened because services tied to a public health need get full payment at 100% of the Medicare-based amount, encouraging pharmacist participation during emergencies.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Medicare coverage for pharmacist care

If enacted, Medicare Part B would cover pharmacist services starting January 1, 2026. Coverage would apply only when State law allows the pharmacist to perform the service and any required doctor supervision or collaboration is met. It would explicitly include visits for testing or treating COVID-19, influenza, RSV, and strep, and services tied to a declared public health emergency. Medicare would pay 80% of the lesser of the pharmacist's charge or a Medicare-based amount (that Medicare amount would be 85% of the usual physician payment, or 100% for public-health emergency services). Pharmacists could not balance-bill Medicare patients for these covered services.

Sponsors & CoSponsors

Sponsor

John Thune

SD • R

Cosponsors

  • Mark Warner

    VA • D

    Sponsored 7/24/2025

  • Thomas Tillis

    NC • R

    Sponsored 7/24/2025

  • Steve Daines

    MT • R

    Sponsored 7/24/2025

  • Maggie Hassan

    NH • D

    Sponsored 7/24/2025

  • Elizabeth Warren

    MA • D

    Sponsored 7/24/2025

  • Peter Welch

    VT • D

    Sponsored 7/24/2025

  • Catherine Cortez Masto

    NV • D

    Sponsored 7/24/2025

  • James Lankford

    OK • R

    Sponsored 7/30/2025

  • Lisa Blunt Rochester

    DE • D

    Sponsored 9/3/2025

  • Kevin Cramer

    ND • R

    Sponsored 9/3/2025

  • Amy Klobuchar

    MN • D

    Sponsored 9/9/2025

  • Dan Sullivan

    AK • R

    Sponsored 9/9/2025

  • Martin Heinrich

    NM • D

    Sponsored 9/17/2025

  • Jeanne Shaheen

    NH • D

    Sponsored 9/17/2025

  • Shelley Capito

    WV • R

    Sponsored 9/17/2025

  • Deb Fischer

    NE • R

    Sponsored 9/17/2025

  • Lisa Murkowski

    AK • R

    Sponsored 10/7/2025

  • Timothy Kaine

    VA • D

    Sponsored 10/7/2025

  • Christopher Coons

    DE • D

    Sponsored 10/8/2025

  • Mike Rounds

    SD • R

    Sponsored 10/8/2025

  • Adam Schiff

    CA • D

    Sponsored 10/14/2025

  • John Kennedy

    LA • R

    Sponsored 10/14/2025

  • Markwayne Mullin

    OK • R

    Sponsored 10/16/2025

  • Roger Marshall

    KS • R

    Sponsored 10/22/2025

  • Marsha Blackburn

    TN • R

    Sponsored 11/20/2025

  • Gary Peters

    MI • D

    Sponsored 11/20/2025

  • Sheldon Whitehouse

    RI • D

    Sponsored 12/2/2025

  • Susan Collins

    ME • R

    Sponsored 2/9/2026

  • Patty Murray

    WA • D

    Sponsored 2/9/2026

Roll Call Votes

No roll call votes available for this bill.

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