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

H.R. 3164 would add a limited new benefit under Medicare Part B so pharmacists can be paid directly for certain services they are already allowed to provide under state law. The bill is focused on testing and treatment tied to COVID-19, flu, RSV, strep throat, and other urgent public health needs declared during a federal public health emergency. In simple terms, it treats pharmacists more like other health professionals for a narrow set of services.

The practical goal is access. In many places, especially rural areas and neighborhoods with fewer doctors, the pharmacy is the most reachable health care site. Supporters argue that if Medicare pays pharmacists for evaluating patients, testing them, and in some cases treating them, seniors could get care faster and avoid delays that can make infections worse.

The bill is not a blanket expansion of pharmacist authority. Pharmacists could only bill Medicare for services they are legally allowed to perform under their state’s rules. If state law requires a pharmacist to work under a doctor’s supervision or through a collaboration agreement, that requirement stays in place. So the bill creates federal payment, but it does not override state scope-of-practice laws.

Payment would generally be set at 80% of the lower of the actual charge or 85% of the physician fee schedule amount for the same service, with a higher 100% benchmark for services tied to a public health emergency need identified by the HHS Secretary. The bill also bars balance billing for these pharmacist services, meaning Medicare patients would have added protection from being charged above the allowed amount. The politics are favorable on the surface: it has bipartisan original sponsors and a large number of cosponsors, but it will still face the usual questions about Medicare spending, provider turf, and how broadly pharmacist care should expand.