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Introduced December 3, 2025 by Jennifer Kiggans · Last progress December 3, 2025
Allows TRICARE beneficiaries, starting Oct 1, 2026, to choose broader delivery options for non‑generic maintenance prescriptions and requires DoD pharmacy contractors to meet minimum reimbursement standards for TRICARE retail pharmacies. It bans contractor-imposed fees on retail TRICARE pharmacies, mandates annual Comptroller General audits of contractor reimbursement/price concession data and network access, and directs the Secretary of Defense to submit an implementation plan within 90 days of enactment.
The bill improves TRICARE beneficiaries' medication choice and strengthens pharmacy payment protections and oversight, but those protections may raise program costs, add administrative complexity, and risk reduced local pharmacy access in some areas.
TRICARE beneficiaries (active-duty, retirees, dependents, and other covered military families) can elect non‑generic maintenance medications beginning Oct 1, 2026, increasing pharmacy choice and continuity of care for long‑term prescriptions.
Retail pharmacies serving TRICARE patients will receive stronger payment protections—minimum reimbursement tied to actual acquisition cost or NADAC proxy plus a State Medicaid dispensing fee, and prohibitions on contractor-imposed point‑of‑sale, retroactive, or hidden fees—reducing unexpected losses and improving financial viability for community pharmacies.
Required DoD implementation planning (90‑day plan) together with annual GAO audits of reimbursement, price concessions, and network adequacy increases transparency and creates an enforceable timeline to identify and address access problems, especially in rural and underserved areas.
Taxpayers and the TRICARE program could face higher costs because higher minimum reimbursements raise defense healthcare spending.
Strict reimbursement floors and bans on certain contractor fees may reduce contractors' flexibility to manage costs, risking narrower pharmacy networks or contractor withdrawal that could limit local access—especially in rural and underserved communities.
Tying dispensing fees to State Medicaid rates could create uneven reimbursement levels across states and add administrative complexity for a nationwide TRICARE contractor, complicating payments for pharmacies and state coordination.