H.R. 3164: Ensuring Community Access to Pharmacist Services Act

H.R. 3164 adds a narrow new benefit to Medicare Part B: pharmacists could bill Medicare directly for testing and treating a specific set of illnesses — COVID-19, the flu, RSV, and strep throat — plus services tied to a federally declared public health emergency. Today Medicare generally won't pay a pharmacist for that kind of visit, even when state law already lets them do it.

The point is reach. In rural areas and neighborhoods short on doctors, the pharmacy is often the closest health care there is, and it's open evenings and weekends. Sponsors argue that paying pharmacists to evaluate, test, and treat these infections gets seniors care sooner — before a manageable bug turns into something worse.

This is not a blanket expansion of what pharmacists can do. A pharmacist could only bill Medicare for services their state already authorizes. If state law requires a pharmacist to work under a doctor's supervision or through a collaboration agreement, that requirement stays. The bill creates federal payment; it does not rewrite state scope-of-practice law.

On money, Medicare would base the allowed amount on 85% of what it pays a physician for the same service — the full physician rate for public health emergency services — then pay its usual 80% share of that. Pharmacists would also fall under Medicare's balance-billing ban, so patients couldn't be charged above the approved amount. The bill is broadly bipartisan, with the sponsor and more than 100 cosponsors from both parties, but it still faces the usual fights over Medicare spending and which provider gets paid for what.