Section 1 Short title
This Act may be cited as the “Equitable Community Access to Pharmacist Services Act”.
Equitable Community Access to Pharmacist Services Act
A BILL
To amend title XVIII of the Social Security Act to provide pharmacy payment of certain services.
Sec. 2 Coverage of pharmacist services under medicare part B
in paragraph (2)—
in subparagraph (II), by striking “and” at the end;
in subparagraph (JJ), by inserting “and” after the semicolon at the end; and
by adding at the end the following new subparagraph:
“(KK) pharmacist services and such services and supplies furnished as an incident to the pharmacist’s service as would otherwise be covered under part B if furnished by a physician or as an incident to a physician’s service that—
“(i) are furnished by a pharmacist—
“(I) as licensed under State law; or
“(II) pursuant to a Federal emergency authority described under section 319F–3 or section 361 of the Public Health Service Act, or other similar Federal law;
“(ii) would otherwise be covered under part B if furnished by a physician; and
“(iii) are services—
“(I) for encounters for the evaluation and management of patients for testing or treatment for COVID–19, influenza, respiratory syncytial virus, or streptococcal pharyngitis; or
“(II) that address a public health need related to a public health emergency under section 319F–3 or section 361 of the Public Health Service Act, or other similar Federal law.”
in paragraph (10), in each of subparagraphs (A) and (B), by inserting “, including when furnished by a pharmacist” before the semicolon in each such subparagraph.
by striking “and (HH)” and inserting “(HH)”; and
by inserting before the semicolon at the end the following: “and (II) with respect to pharmacist services described in section 1861(s)(2)(KK), the amounts paid shall be equal to 80 percent of the lesser of (i) the actual charge for the services or (ii) 85 percent (or 100 percent, in the case of such services furnished pursuant to a Federal emergency authority described in clause (i)(II) of such section) of the amount determined under the payment basis under section 1848 for such services.”.
Prohibition on balance billing for pharmacist services— Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following:
“(ix) A pharmacist.”
Rule of construction— Nothing in this section shall be construed to restrict the ability of pharmacies and pharmacists to enroll and obtain reimbursement under existing pathways under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) as of the date of the enactment of this Act, including payment as mass immunizers.
Implementation authority— Notwithstanding any other provision of law, the Secretary of Health and Human Services shall implement the provisions of, and the amendments made by, this section by interim final rule, program instruction, or otherwise not later than the date that is 60 days after the date of the enactment of this Act.