Rx ACCESS Act

The Rx ACCESS Act seeks to significantly improve the TRICARE pharmacy benefits program by enhancing beneficiary access and ensuring equitable practices for retail pharmacies. Starting October 1, 2026, eligible TRICARE beneficiaries will gain the flexibility to choose their preferred method for receiving non-generic prescription maintenance medications, removing previous restrictions. A key provision of this legislation establishes new pharmacy benefit manager (PBM) reimbursement standards . It mandates that PBMs reimburse TRICARE retail pharmacies at a rate that covers at least the actual acquisition cost of the drug (or a national average proxy) plus a professional dispensing fee equivalent to the state's Medicaid rate. Furthermore, the bill explicitly prohibits PBMs from imposing various fees on retail pharmacies, including point-of-sale, retroactive, or other hidden charges, aiming to ensure greater financial transparency and fairness. To ensure accountability and oversight, the Act requires the Comptroller General of the United States to conduct annual audits of PBM reimbursement rates, price concessions, and the adequacy of the TRICARE retail pharmacy network, particularly in rural and underserved areas. Additionally, the Secretary of Defense must submit an implementation plan for these changes within 90 days of the Act's enactment.