The "Preserving Patient Access to Long-Term Care Pharmacies Act" aims to support long-term care pharmacies and ensure patient access to medications by implementing temporary supply fees under Medicare Part D. For plan years 2026 and 2027 , prescription drug plan sponsors and Medicare Advantage organizations offering prescription drug plans will be required to pay long-term care pharmacies a supply fee for certain specified prescriptions. This fee will be $30 in 2026 , with the 2027 amount adjusted for inflation, and must be paid in addition to, and without reducing, other pharmacy reimbursements like ingredient costs or dispensing fees. To ensure compliance, the Secretary of Health and Human Services is authorized to impose civil money penalties of at least $10,000 on plans that fail to pay these fees. The bill also provides for the Secretary to reimburse these plans for the aggregate amount of supply fees they pay to long-term care pharmacies during these two years. Furthermore, the legislation mandates a Government Accountability Office (GAO) study and report to Congress within 12 months of enactment. This study will analyze the economic sustainability of long-term care pharmacies participating in the Medicare prescription drug program, examining payment structures, compliance costs, and recent payment changes. The GAO report will also include recommendations for creating a sustainable payment system to ensure uninterrupted access to long-term care pharmacy services for Medicare beneficiaries, particularly in rural markets.