Preserving Patient Access to Long-Term Care Pharmacies Act
Summary
H.R. 5031, the "Preserving Patient Access to Long-Term Care Pharmacies Act," aims to amend Title XVIII of the Social Security Act. The bill introduces temporary long-term care pharmacy supply fees for specific drugs dispensed to certain Medicare beneficiaries. It also mandates a GAO study on the economic sustainability of long-term care pharmacies within the Medicare prescription drug program.
Expected Effects
The bill will provide temporary financial relief to long-term care pharmacies by establishing supply fees for prescriptions dispensed to applicable maximum fair price eligible individuals. This could help ensure continued access to pharmacy services for Medicare beneficiaries in long-term care facilities. The GAO study will inform future policy decisions regarding long-term care pharmacy reimbursement.
Potential Benefits
- Ensures continued access to medications for Medicare beneficiaries in long-term care.
- Provides temporary financial support to long-term care pharmacies.
- Increases reimbursement for pharmacies serving a vulnerable population.
- Mandates a GAO study to assess the long-term economic sustainability of these pharmacies.
- Potentially improves the financial stability of long-term care pharmacies, particularly in rural areas.
Potential Disadvantages
- The supply fees are temporary, expiring after two years (2026 and 2027).
- The bill only addresses payment for a specific subset of prescriptions.
- The increased costs to the government could potentially lead to higher premiums or reduced benefits elsewhere in the Medicare program.
- The definition of "applicable maximum fair price eligible individual" may limit the scope of the benefit.
- The GAO study may reveal underlying issues that the temporary supply fees do not address.
Constitutional Alignment
The bill aligns with the General Welfare Clause (Article I, Section 8) by aiming to ensure access to healthcare services for a vulnerable population. Congress has broad authority to legislate on matters related to Medicare under this clause. The bill does not appear to infringe upon any specific constitutional rights or limitations.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).