The bill would change the Social Security Act to let Medicare Part B cover certain services provided by pharmacists. It adds a new definition of "pharmacist services" and says those services count as covered when a pharmacist is legally allowed by State law to give them and when State rules about supervision or collaboration with a physician or practitioner are followed. Covered services include visits for evaluation and management for testing or treatment of COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis, and other testing or treatment services that address a public health need during a declared public health emergency (as determined by the Secretary).
The bill also sets payment rules. Medicare would pay 80 percent of the lesser of the actual charge or a percentage of the amount set under the physician payment basis (85 percent in most cases, or 100 percent for services that address the public health need described above). The bill adds pharmacists to the part of the law that prohibits balance billing. The changes would apply to items and services furnished on or after January 1, 2026.
No publicly available information on the bill's estimated federal cost. The bill specifies how Medicare would pay for these services (80 percent of the lesser of the actual charge or 85 percent of the physician-based amount, or 100 percent for certain public-health-need services), but it does not provide an overall cost estimate.
No publicly available information.
No publicly available information.