S2426119th CongressWALLET

Equitable Community Access to Pharmacist Services Act

Sponsored By: Senator Thune, John [R-SD]

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

Thune, John [R-SD]

SD • R

Cosponsors

  • Sen. Warner, Mark R. [D-VA]

    VA • D

    Sponsored 7/24/2025

  • Sen. Tillis, Thomas [R-NC]

    NC • R

    Sponsored 7/24/2025

  • Sen. Daines, Steve [R-MT]

    MT • R

    Sponsored 7/24/2025

  • Sen. Hassan, Margaret Wood [D-NH]

    NH • D

    Sponsored 7/24/2025

  • Sen. Warren, Elizabeth [D-MA]

    MA • D

    Sponsored 7/24/2025

  • Peter Welch

    VT • D

    Sponsored 7/24/2025

  • Sen. Cortez Masto, Catherine [D-NV]

    NV • D

    Sponsored 7/24/2025

  • Sen. Lankford, James [R-OK]

    OK • R

    Sponsored 7/30/2025

  • Sen. Blunt Rochester, Lisa [D-DE]

    DE • D

    Sponsored 9/3/2025

  • Sen. Cramer, Kevin [R-ND]

    ND • R

    Sponsored 9/3/2025

  • Amy Klobuchar

    MN • D

    Sponsored 9/9/2025

  • Dan Sullivan

    AK • R

    Sponsored 9/9/2025

  • Sen. Heinrich, Martin [D-NM]

    NM • D

    Sponsored 9/17/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 9/17/2025

  • Shelley Capito

    WV • R

    Sponsored 9/17/2025

  • Sen. Fischer, Deb [R-NE]

    NE • R

    Sponsored 9/17/2025

  • Sen. Murkowski, Lisa [R-AK]

    AK • R

    Sponsored 10/7/2025

  • Sen. Kaine, Tim [D-VA]

    VA • D

    Sponsored 10/7/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 10/8/2025

  • Mike Rounds

    SD • R

    Sponsored 10/8/2025

  • Sen. Schiff, Adam B. [D-CA]

    CA • D

    Sponsored 10/14/2025

  • Sen. Kennedy, John [R-LA]

    LA • R

    Sponsored 10/14/2025

  • Markwayne Mullin

    OK • R

    Sponsored 10/16/2025

  • Sen. Marshall, Roger [R-KS]

    KS • R

    Sponsored 10/22/2025

  • Sen. Blackburn, Marsha [R-TN]

    TN • R

    Sponsored 11/20/2025

  • Gary Peters

    MI • D

    Sponsored 11/20/2025

  • Sen. Whitehouse, Sheldon [D-RI]

    RI • D

    Sponsored 12/2/2025

  • Sen. Collins, Susan M. [R-ME]

    ME • R

    Sponsored 2/9/2026

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 2/9/2026

Roll Call Votes

No roll call votes available for this bill.

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