S2426HealthSenate

Equitable Community Access to Pharmacist Services Act

Introduced Jul 24, 202527 cosponsorsCongress.gov

Sponsor

John Thune

Republican · SD

Latest Action · Jul 24, 2025

Read twice and referred to the Committee on Finance.

Bill Progress

IntroducedJul 24

Committee

Pass Senate

Pass House

Signed

Law

Congress moves to make pharmacists frontline clinicians

Why it matters

Letting pharmacists bill Medicare for basic services could quietly shift who actually delivers primary care in much of the country.

S.2426, the "Equitable Community Access to Pharmacist Services Act," would let Medicare treat pharmacists more like frontline clinicians — paying them for vaccinations, chronic‑disease checks and other services they’re already allowed to perform under state law. The move is aimed squarely at the primary‑care crunch in rural and underserved communities, where the drugstore often outlasts the local doctor’s office and becomes the only walk‑in health hub for miles.

Pharmacist groups argue the bill simply lets Medicare catch up to reality, where pharmacists already do medication management, point‑of‑care testing and chronic‑care counseling but can’t bill Part B for it. Long‑term care and senior‑care pharmacists have pressed lawmakers to recognize them as part of the primary‑care safety net, warning that without sustainable payment, independents in small towns will keep shuttering and older adults will lose one of the last accessible clinicians they see in person. They pitch S.2426 as a limited, targeted fix: Medicare could pay pharmacists only for services they’re allowed to do under state law and that would otherwise be covered when delivered by a physician.

Physician groups see a slippery slope. Organized medicine has spent years insisting that physician‑led care is the safest model, arguing that complex, older patients need teams anchored by doctors who can diagnose, manage multiple conditions and coordinate specialty referrals. Letting Medicare carve out a bigger billable role for pharmacists, they warn, risks normalizing a two‑tier system where urban seniors get integrated, physician‑led care while rural and low‑income patients are steered toward stand‑alone pharmacies for fragments of that same care.

What This Bill Does

Lets Medicare pay pharmacists for certain medical services

The bill adds “pharmacist services” as something Medicare Part B can cover, similar to how it already pays doctors. This means, in some situations, Medicare can pay a pharmacist not just for filling a prescription, but for the medical service they provide.

Defines which pharmacist services can be covered

The bill says pharmacist services are only covered if they’re things the pharmacist is allowed to do under state law and that Medicare would normally pay for if a doctor did them. So pharmacists don’t get new powers from this bill; Medicare just agrees to pay them for services they’re already legally allowed to perform.

Limits coverage to testing and treatment for specific infections and public health emergencies

Medicare can pay pharmacists for visits to check and treat people for COVID‑19, the flu, RSV, and strep throat. It can also pay for testing or treatment services that respond to any declared public health emergency, but only if the federal health secretary decides those services qualify.

Requires pharmacist work to fit state rules on supervision or collaboration

If a state says pharmacists must work under a doctor’s supervision or in collaboration with a doctor or other practitioner, then Medicare will only pay when those conditions are followed. The bill spells out that “collaboration” means the pharmacist and doctor work together under state‑approved guidelines with medical direction and oversight.

Aligns pharmacist services with existing doctor service rules for Medicare payment

The bill tweaks the Medicare payment section so pharmacist services can be slotted into the same kind of payment setup used for doctors. In practice, this creates a path for Medicare to actually cut checks for these pharmacist visits instead of treating them as unpaid extras.

Who Benefits

Medicare patients who need quick care for infections

People on Medicare (mostly seniors and some disabled adults) could get tested and treated for things like COVID‑19, flu, RSV, and strep throat directly at pharmacies, if their state allows it. This can mean faster care and fewer trips to a doctor’s office or urgent care, especially in places with few clinics.

Community and retail pharmacists

Pharmacists can get paid by Medicare for clinical work they’re already doing or are allowed to do, like evaluating symptoms, ordering tests, and starting treatment for certain infections. That turns what might have been free help or gray‑area work into a recognized, billable service, potentially boosting their income and status as part of the care team.

Doctors and other clinicians who work with pharmacists

Physicians and other Medicare‑recognized practitioners can formally collaborate with pharmacists, letting pharmacists handle some basic infection testing and treatment. This can ease the workload on clinics by off‑loading straightforward cases to pharmacists while still keeping medical oversight as state law requires.

Communities facing public health emergencies

During things like pandemics or other declared health crises, communities can use pharmacies as extra access points for testing and treatment. Because Medicare will pay pharmacists for these services, it becomes easier to stand up more local care options quickly.

Who's Affected

Pharmacies and pharmacy owners

They will need to set up billing processes and documentation to meet Medicare’s requirements for these newly covered services. Day‑to‑day, this could mean scheduling short clinical visits, keeping more detailed charts, and coordinating closely with supervising or collaborating doctors where state law requires it.

Pharmacists providing direct patient care

Pharmacists who actually see patients will have to follow state rules on supervision or collaboration and make sure their services match what Medicare says it will cover. Their daily work may include more patient evaluations and testing, not just checking prescriptions, and more time spent on paperwork and communication with doctors.

State regulators and boards of pharmacy/medicine

Because Medicare coverage depends on what state law allows pharmacists to do and how collaboration is defined, state rules effectively decide how much this bill can be used. States may face pressure to clarify or update their laws on pharmacist scope of practice and collaboration agreements.

Medicare program administrators

Medicare officials will have to create billing codes, payment rules, and guidelines for what counts as covered pharmacist services, especially for public health emergencies. They’ll also need to decide, during emergencies, which pharmacist‑provided tests and treatments qualify for payment.

Cosponsors (27)

Mark Warner

Democrat · VA

Thomas Tillis

Republican · NC

Steve Daines

Republican · MT

Maggie Hassan

Democrat · NH

Elizabeth Warren

Democrat · MA

Peter Welch

Democrat · VT

Catherine Cortez Masto

Democrat · NV

James Lankford

Republican · OK

Lisa Blunt Rochester

Democrat · DE

Kevin Cramer

Republican · ND

Amy Klobuchar

Democrat · MN

Dan Sullivan

Republican · AK

Recent Actions

Jul 24, 2025

Read twice and referred to the Committee on Finance.

Jul 24, 2025

Introduced in Senate

What Changes in the Law

4 key amendments · 4 total changes

Full Text

Social Security Act, Section 1861(s)(2)

in subsection (s)(2)—
  (A) in subparagraph (JJ), by adding ‘‘and’’ at the end; and
  (B) by adding at the end the following new subparagraph:
  ‘‘(KK) pharmacist services (as defined in subsection (nnn));’’;

What this means: Medicare Part B’s list of covered services is expanded to include a new category: pharmacist services, as defined in a new subsection.

Social Security Act, Section 1861

by adding at the end the following new subsection:
  ‘‘(nnn) PHARMACIST SERVICES.—
    ‘‘(1) IN GENERAL.—The term ‘pharmacist services’ means such services furnished by a pharmacist, and such services and supplies furnished as an incident to the pharmacist’s service, which the pharmacist is legally authorized to perform under State law as would otherwise be covered if furnished by a physician or as an incident to a physicians’ service which—
      ‘‘(A) in the case such State law requires such services to be furnished under the supervision of, or working in collaboration with, a physician or practitioner (as defined in section 1842(b)(18)(C)(i)), are so furnished under the supervision of, or working in collaboration with, such physician or practitioner in the manner and to the extent as so required by such State law; and
      ‘‘(B) are—
        ‘‘(i) for visits for the evaluation and management of individuals for testing or treatment for COVID–19, influenza, respiratory syncytial virus, or streptococcal pharyngitis; or
        ‘‘(ii) testing or treatment services that address a public health need related to a public health emergency declared under section 319 of the Public Health Service Act (as determined by the Secretary).
    ‘‘(2) COLLABORATION.—For purposes of this subsection, the term ‘collaboration’ means a process in which a pharmacist works with a physician or practitioner (as defined in section 1842(b)(18)(C)(i)), as applicable, to deliver health care services within the scope of the pharmacist’s professional expertise, with medical direction and appropriate supervision as provided for in jointly developed guidelines or other mechanisms as defined by the law of the State in which the services are performed.’’.

What this means: A new statutory definition of “pharmacist services” is created for Medicare, specifying which pharmacist‑furnished clinical services can be covered (e.g., testing and treatment for COVID‑19, flu, RSV, strep, and services tied to declared public health emergencies) and how collaboration/supervision with physicians must work under state law.

Social Security Act, Section 1861(nnn)(1)(B)(i)–(ii)

‘‘(B) are—
  ‘‘(i) for visits for the evaluation and management of individuals for testing or treatment for COVID–19, influenza, respiratory syncytial virus, or streptococcal pharyngitis; or
  ‘‘(ii) testing or treatment services that address a public health need related to a public health emergency declared under section 319 of the Public Health Service Act (as determined by the Secretary).’’

What this means: The statute explicitly limits covered pharmacist services to certain infectious disease testing and treatment visits and to services related to federally declared public health emergencies.

Social Security Act, Section 1833(a)(1)

−

‘‘and (HH)’’

(1) by striking ‘‘and (HH)’’ and inserting ‘‘(HH)’’; and
(2) by inserting before the semicolon at the end the following: ‘‘, and (II) with respect to pharmacist se

What this means: Medicare’s Part B payment formula in section 1833(a)(1) is modified to add a new payment category for pharmacist services, ensuring there is an explicit payment mechanism for the newly covered pharmacist services (the detailed rate language continues beyond the provided excerpt).