This legislation seeks to enhance the TRICARE pharmacy benefits program by increasing beneficiary flexibility and establishing new standards for pharmacy reimbursement. Beginning October 1, 2026, it grants eligible TRICARE beneficiaries the ability to choose their preferred method for receiving non-generic prescription maintenance medications, expanding their options beyond current limitations. The bill mandates that the Secretary of Defense ensure pharmacy benefit manager (PBM) contracts provide retail pharmacies with minimum reimbursement rates. These rates must cover the actual acquisition cost or a proxy based on the national average drug acquisition cost, plus a professional dispensing fee equivalent to the state's Medicaid rate. Furthermore, it prohibits PBMs from imposing hidden or retroactive fees on retail pharmacies. To ensure accountability and transparency, the bill requires the Comptroller General to conduct annual audits of PBM reimbursement data and assess the adequacy of the TRICARE retail pharmacy network, including access in rural and underserved areas.
Accounting and auditingCongressional oversightHealth care coverage and accessMilitary medicinePrescription drugs
Rx ACCESS Act
USA119th CongressS-4106| Senate
| Updated: 4/13/2026
This legislation seeks to enhance the TRICARE pharmacy benefits program by increasing beneficiary flexibility and establishing new standards for pharmacy reimbursement. Beginning October 1, 2026, it grants eligible TRICARE beneficiaries the ability to choose their preferred method for receiving non-generic prescription maintenance medications, expanding their options beyond current limitations. The bill mandates that the Secretary of Defense ensure pharmacy benefit manager (PBM) contracts provide retail pharmacies with minimum reimbursement rates. These rates must cover the actual acquisition cost or a proxy based on the national average drug acquisition cost, plus a professional dispensing fee equivalent to the state's Medicaid rate. Furthermore, it prohibits PBMs from imposing hidden or retroactive fees on retail pharmacies. To ensure accountability and transparency, the bill requires the Comptroller General to conduct annual audits of PBM reimbursement data and assess the adequacy of the TRICARE retail pharmacy network, including access in rural and underserved areas.