S4106119th CongressWALLET

Rx ACCESS Act

Sponsored By: Senator Tom Cotton

Introduced

Summary

Require minimum reimbursements to retail pharmacies under TRICARE. The Rx ACCESS Act would let eligible covered beneficiaries choose how they receive non‑generic maintenance medicines and would set floor payment rules and new oversight for pharmacy benefits.

Show full summary
  • Eligible TRICARE beneficiaries would be able to elect to receive non‑generic maintenance prescriptions through any authorized pharmacy channel described in law starting October 1, 2026.
  • Retail pharmacies in the TRICARE network would receive reimbursements at least equal to their acquisition cost or a proxy based on the national average drug acquisition cost index plus a professional dispensing fee equal to the State Medicaid dispensing fee. Contractors would be barred from imposing point‑of‑sale, retroactive, or other hidden fees on retail pharmacies.
  • Annual audits by the Comptroller General would review contractor‑reported reimbursement and price concession data and assess pharmacy network adequacy, including continuity of care and rural access. The Secretary of Defense would have to provide needed data and submit a 90‑day plan for implementation.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Higher minimum payments for TRICARE pharmacies

If enacted, this bill would require TRICARE pharmacy contractors to pay in-network retail pharmacies at least the pharmacy's purchase cost or a NADAC-based price plus the State Medicaid dispensing fee. If a drug appears on CMS's NADAC index, the payment proxy could not be lower than the NADAC amount on the adjudication date. The bill would also bar the TRICARE contractor from charging point-of-sale fees, retroactive fees, or other hidden fees to retail pharmacies. These rules would apply as a condition of TRICARE pharmacy benefits contracts and take effect upon enactment.

More TRICARE pharmacy options and oversight

If enacted, this bill would set October 1, 2026 as the date when eligible TRICARE beneficiaries may elect to receive non-generic maintenance medicines by the delivery options listed in paragraph (2)(E). It would also require the Comptroller General to audit TRICARE pharmacy reimbursement and retail network adequacy at least once a year. Audits must check contractor-reported reimbursement data and price concessions, continuity of care, and geographic access with attention to rural and underserved areas. The Comptroller General would send results to the House and Senate Armed Services Committees, and the Secretary must ensure contractors give the needed information. The Secretary would also have to submit an implementation plan within 90 days after enactment.

Sponsors & CoSponsors

Sponsor

Tom Cotton

AR • R

Cosponsors

  • Timothy Kaine

    VA • D

    Sponsored 3/17/2026

  • Shelley Capito

    WV • R

    Sponsored 3/24/2026

Roll Call Votes

No roll call votes available for this bill.

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