Medicare Part D Eyes Fairer Pharmacy Contracting Standards by 2029
Published Date: 9/24/2026
Proposed Rule
Summary
Medicare Part D is asking for ideas on fair and clear rules for pharmacy contracts starting in 2029. This means pharmacies that meet these new standards can join Medicare’s network, helping more people get their prescriptions easily. If you have thoughts, speak up by November 23, 2026, so your voice shapes the future of pharmacy deals and patient care!
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Pharmacies Must Be Allowed In If They Meet Standards
For Medicare Part D plans, any pharmacy that meets the plan's standard contract terms and conditions must be allowed to join the plan's network starting for plan years beginning on or after January 1, 2029. The Secretary of HHS must set standards for what ‘‘reasonable and relevant’’ terms mean no later than the first Monday in April of 2028.
CMS Seeks Input on Reimbursement, Audits, and More
CMS is requesting public input to help set the standards and is asking for information on topics such as pharmacy reimbursement and dispensing fees, MAC pricing and benchmarks, use of aggregate guarantees, 340B-related contract terms, specialty pharmacy designations, audits and recoupments, quality measures, PBM relationships, and implementation timelines. Comments are requested to inform future standards and must be received by November 23, 2026.
Personalized for You
How does this regulation affect your finances?
Personalize government policy and PRIA will tell you what this federal register document means for your household, plus every other regulation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-20281, Global Benchmark for Efficient Drug Pricing (GLOBE) Model
Starting November 30, 2026, Medicare will use the new GLOBE Model to help lower the cost of certain drugs for people on Original Medicare. This model changes how drug price increases are calculated, aiming to save money for both patients and the Medicare program without cutting care quality. If you’re on Medicare Part B, expect smarter drug pricing that helps keep your healthcare affordable.
2026-20131, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program; Correction
This correction fixes some technical mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2026. It mainly affects hospitals and rehab centers by clarifying how wage data and payments are calculated, ensuring fairer payment rates for fiscal year 2027. No big changes in money, but it keeps everything accurate and on track.
2026-19959, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027; Correction
This correction fixes some technical mistakes in Medicare payment rules for skilled nursing facilities starting October 1, 2026. It mainly affects how hospital data is used to calculate payments, making sure no current hospitals are wrongly excluded. These tweaks help keep Medicare payments fair and accurate for providers and patients.
2026-20067, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction
This correction fixes some technical mistakes in the FY 2027 hospice payment and wage index rules that were first published in August 2026. It mainly affects hospice providers by updating how their payments are calculated, making sure the numbers are accurate starting October 1, 2026. These changes help ensure hospices get the right payment amounts based on the latest hospital wage data.
2026-19946, Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; Other Policy Changes; and Adoption of Updated Versions of Certain Health Information Technology Standards; Correction
This update fixes some typos and technical mistakes in the Medicare payment rules for hospitals starting October 1, 2026. It affects hospitals getting paid for patient care, making sure the payment system and quality programs run smoothly. These corrections help hospitals get the right payments and follow updated health tech standards without delays or confusion.
2026-15686, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program.
Previous / Next Documents
Previous: 2026-19532, Amendments To Import Requirements for Highly Pathogenic Avian Influenza
The USDA is proposing to shorten the waiting time for importing live birds and bird products from 90 days to 28 days after a highly pathogenic avian influenza (HPAI) outbreak. This change helps foreign exporters get back to business faster while keeping the U.S. safe from bird flu. If you’re involved in bird imports, get ready to comment by November 23, 2026, and watch for updates that could speed up trade without extra costs.
Next: 2026-19546, Small Business Size Standards
The Small Business Administration is giving small businesses more time to share their thoughts on new rules about what counts as a 'small business.' The comment period is extended by 60 days, now ending November 20, 2026. This helps businesses understand and possibly benefit from updated size standards that could affect their eligibility for government programs and contracts.