Ensuring Community Access to Pharmacist Services Act (H.R. 3164)
May 1, 2025
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Where This Stands
Currently in_committee. The next step in the legislative lifecycle is Floor Vote.
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Finance Connection
| Candidate | Donor | Amount | Industry | Date |
|---|---|---|---|---|
| Schneider for City Council 2020 | Mohammad Monshizadeh | $200 | Vice President | Oct 2020 |
Reported financial relationships and timing signals. This does not prove motive or influence. Readers draw their own conclusions.
The Frame
Starting January 1, 2026, Medicare beneficiaries could receive coverage for pharmacist-led testing and treatment for illnesses like COVID-19, flu, and strep throat, potentially increasing access to care in local pharmacies.
Potentially affected actors named in the source documents. Mention is not a position.
Medicare beneficiaries
They would gain access to Medicare-covered testing and treatment services provided by pharmacists.
Pharmacists
They would be eligible to receive Medicare reimbursement for specific clinical services provided they meet state law and collaboration requirements.
Physicians
They may be required to enter into collaborative agreements or provide supervision for pharmacists performing these services, depending on state law.
Current stage: in_committee.
Floor Vote.
Summary
Why It Matters
Starting January 1, 2026, Medicare beneficiaries could receive coverage for pharmacist-led testing and treatment for illnesses like COVID-19, flu, and strep throat, potentially increasing access to care in local pharmacies.
Key Facts
- The bill amends Medicare Part B to include coverage for specific pharmacist-provided services.
- Covered services include evaluation, testing, and treatment for COVID-19, influenza, respiratory syncytial virus (RSV), and streptococcal pharyngitis.
- Pharmacists may provide services related to public health emergencies as declared by the Secretary of Health and Human Services.
- Services must be performed within the scope of state law and, where required, under the supervision of or in collaboration with a physician.
- Medicare payment for these services is set at 80% of the lesser of the actual charge or 85% of the standard physician fee schedule.
- For public health emergency services, the payment rate is 80% of the lesser of the actual charge or 100% of the standard physician fee schedule.
- The bill prohibits 'balance billing,' meaning pharmacists cannot charge patients for the difference between their fee and the Medicare-approved amount.
- The provisions of this act are scheduled to take effect on January 1, 2026.
Frequently Asked Questions
Will Medicare cover my pharmacy visit for a flu test?
Can a pharmacist charge me extra if Medicare doesn't pay the full amount?
News Coverage
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Expansion of Pharmacist Scope
The bill represents a shift toward integrating pharmacists into the primary care reimbursement structure for Medicare, specifically for infectious disease testing.
Connected Entities
Analysis Score
0–100- Significance65How much this matters to a regular citizen
- Controversy20Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz30Current news / social attention level
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