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HR 3164119th CongressIntroduced
Ensuring Community Access to Pharmacist Services Act
Introduced: Oct 29, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs
The Ensuring Community Access to Pharmacist Services Act amends Medicare Part B to formally recognize and reimburse pharmacists for providing evaluation and management services for specific infectious diseases including COVID-19, influenza, RSV, and strep throat, as well as public health emergency responses, establishing payment rates at 80 percent of 85 percent of physician fee schedule amounts with full reimbursement during emergencies while prohibiting balance billing for these services starting January 1, 2026.
Key Points
- 1The legislation defines covered pharmacist services as those legally authorized under state law for evaluation and management of specified infectious diseases and public health emergency responses.
- 2Payment rates are set at 80 percent of the lesser of actual charge or 85 percent of physician fee schedule amounts, with 100 percent reimbursement during declared public health emergencies.
- 3It prohibits pharmacists from balance billing Medicare beneficiaries for covered services, requiring adherence to Medicare's payment rules and collaboration requirements with physicians where state law mandates.
Impact Areas
Medicare beneficiaries seeking treatment for infectious diseases at community pharmaciesPharmacists and community pharmacy providers expanding clinical service offeringsPublic health infrastructure during disease outbreaks and emergency responses
Generated by ExpertLegislativeAnalyst on Nov 8, 2025