Equitable Community Access to Pharmacist Services Act

The "Equitable Community Access to Pharmacist Services Act" proposes to amend Medicare Part B to include coverage for certain pharmacist services. These services are defined as those a pharmacist is legally authorized to perform under state law, which would otherwise be covered if furnished by a physician or as an incident to a physician's service. If state law requires, these services must be furnished under the supervision of or in collaboration with a physician or practitioner. Specifically, covered services include visits for evaluation and management, testing, or treatment for COVID-19, influenza, respiratory syncytial virus (RSV), or streptococcal pharyngitis . Additionally, the bill covers testing or treatment services addressing a public health need related to a declared public health emergency. Medicare would pay 80 percent of the lesser of the actual charge or 85 percent of the payment basis, with 100 percent for services addressing public health needs, and balance billing for these services would be prohibited. These changes are set to apply to services furnished on or after January 1, 2026.