The "Preserving Patient Access to Long-Term Care Pharmacies Act" aims to ensure the economic sustainability of long-term care pharmacies and maintain patient access to their services. For plan years 2026 and 2027, the bill mandates that Medicare Part D prescription drug plans and Medicare Advantage plans offering drug coverage pay a new supply fee to long-term care pharmacies. This fee, set at $30 for 2026 and adjusted for 2027, applies to specific prescriptions dispensed to individuals eligible for drugs at a maximum fair price. Crucially, this supply fee is intended to be an additional payment , separate from and not reducing other pharmacy reimbursements like ingredient costs or dispensing fees. To ensure compliance, the Secretary is authorized to impose civil money penalties of at least $10,000 on plans that fail to pay these fees. Furthermore, the bill stipulates that the Secretary will provide subsidies to these plans, reimbursing them for the aggregate amount of supply fees paid to long-term care pharmacies during those plan years. Beyond the temporary fee structure, the legislation also requires the Comptroller General of the United States to conduct a comprehensive study on the economic sustainability of long-term care pharmacies within the Medicare prescription drug program. This study will analyze payment structures, compliance costs, and historical payment changes, ultimately providing recommendations to Congress and the Secretary of Health and Human Services. The goal is to create a sustainable payment system that guarantees uninterrupted access to long-term care pharmacy services for Medicare beneficiaries, particularly in rural markets.