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Preserving Patient Access to Long-Term Care Pharmacies Act

H.R. 5031 Rep. Beth Van Duyne (R-TX-24) In committee
Bill text PDF
  1. Introduced Aug 22
  2. Committee Aug 22
  3. Passed House Next
  4. Passed Senate Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Aug 22, 2025Next: House vote
432d ago Aug 22, 2025: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Final votes
No roll callsNo recorded vote on this bill yet
Lobbying
4companies, 24 filings
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Summary

This bill temporarily adds a supply fee for long-term care pharmacies when they dispense certain drugs to eligible individuals under Medicare Part D for plan years 2026 and 2027, requires plan sponsors and MA organizations to pay that fee, provides government subsidies to reimburse those payments, and mandates a study on the economic sustainability of long-term care pharmacies in the Medicare drug program.

Sec. 2, Long-term care pharmacy supply fee: For plan years 2026 and 2027, each prescription drug plan sponsor and Medicare Advantage organization offering a Part D plan must pay a long-term care pharmacy a supply fee of $30 for plan year 2026, and for 2027 that amount increased by the annual percentage increase used for other Part D payments, for each specified prescription dispensed to an applicable maximum fair price eligible individual at the maximum fair price. This fee is paid in addition to other pharmacy reimbursements and cannot reduce them. The Secretary must impose a civil money penalty of at least $10,000 for each failure to pay the fee. The section defines key terms including "long-term care pharmacy" (a pharmacy with taxonomy code 3336L0003X), "specified prescription" (a covered Part D drug dispensed at the maximum fair price to an eligible individual), and "maximum fair price eligible individual."

Repayment of long-term pharmacy supply fees: For plan years 2026 and 2027, the Secretary must provide subsidies to plan sponsors and MA organizations equal to the total supply fees they paid to long-term care pharmacies during the plan year, with payment due no later than 18 months after the plan year ends.

GAO study and report: Within 12 months of enactment, the Comptroller General must study and report to Congress on the economic sustainability of long-term care pharmacies in the Medicare Part D program. The report must analyze ingredient costs and dispensing fees for brand-name and generic drugs, compliance costs for network criteria, and payment changes over the prior five years, and include recommendations for a sustainable payment system ensuring uninterrupted access, especially in rural markets.

Summary of the bill text as introduced in House (Aug 22, 2025), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 27, 2026.