Preserving Patient Access to Long-Term Care Pharmacies Act

This bill requires Medicare drug plans to pay long-term care pharmacies a temporary “supply fee” for certain prescriptions filled at Medicare’s “maximum fair price.” The goal is to help keep these pharmacies financially stable so people with long-term care needs can keep getting their medicines.

The fee is $30 per prescription in 2026, and it increases in 2027 by an annual adjustment. It must be paid on top of normal pharmacy payments and cannot be used to lower those payments. Plans that fail to pay face at least a $10,000 penalty for each missed payment.

To offset the cost, the federal government will repay plans for the total supply fees they paid for 2026 and 2027, with repayment due within 18 months after each plan year. The Government Accountability Office must also study whether long-term care pharmacies can sustainably serve Medicare patients and recommend steps to ensure access, including in rural areas.

Key points

• Who is affected: Long-term care pharmacies; Medicare drug plan sponsors; Medicare patients whose prescriptions are filled at the “maximum fair price.”
• What changes: A temporary per-prescription supply fee; penalties for plans that don’t pay; federal repayment to plans; and a federal study on access and payment.
• When: Applies to plan years 2026 and 2027; repayments to plans within 18 months after each plan year; study due within 12 months of enactment.