2026-19535Proposed RuleWallet

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.

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Key Dates

Published Date
Comments Due
9/24/2026
11/23/2026

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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