Protect Patient Access to Pharmacies Act This bill establishes certain requirements with respect to payments to pharmacies by prescription drug plan (PDP) sponsors under the Medicare prescription drug benefit and Medicare Advantage. Specifically, the Centers for Medicare & Medicaid Services (CMS) must ensure that payments sufficiently cover a pharmacy's costs to acquire and dispense covered drugs so as to enable the pharmacy to participate as a network provider. The CMS must (1) use relevant data from pharmacies with respect to acquisition and dispensing costs for covered drugs, (2) establish payment parameters, and (3) establish an appeal process for pharmacies about payments. The CMS must also evaluate the performance measures used by PDP sponsors for pharmacy price concessions or other performance fees and develop standardized performance measures.
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Timeline
Introduced in Senate
Read twice and referred to the Committee on Finance.
Introduced in Senate
Read twice and referred to the Committee on Finance.
Health
Protect Patient Access to Pharmacies Act
USA118th CongressS-2052| Senate
| Updated: 6/20/2023
Protect Patient Access to Pharmacies Act This bill establishes certain requirements with respect to payments to pharmacies by prescription drug plan (PDP) sponsors under the Medicare prescription drug benefit and Medicare Advantage. Specifically, the Centers for Medicare & Medicaid Services (CMS) must ensure that payments sufficiently cover a pharmacy's costs to acquire and dispense covered drugs so as to enable the pharmacy to participate as a network provider. The CMS must (1) use relevant data from pharmacies with respect to acquisition and dispensing costs for covered drugs, (2) establish payment parameters, and (3) establish an appeal process for pharmacies about payments. The CMS must also evaluate the performance measures used by PDP sponsors for pharmacy price concessions or other performance fees and develop standardized performance measures.