Pharmacy Practice NewsMain Street Pharmacy Access Act Revives Push to Pay Pharmacists Under Medicare

⚖️ Legal / Ethical Complexity

The Main Street Pharmacy Access Act cleared the House Ways and Means Committee on May 21, advancing bipartisan legislation that would recognize pharmacists as eligible Medicare providers for the first time under the Social Security Act. Final passage is anticipated as part of a larger legislative package following the November midterms, according to ASHP government relations leadership.

What’s at Stake

• Medicare provider recognition would establish a federal precedent with downstream implications for private payer contracting, extending pharmacist reimbursement beyond the Medicare population
• Ambulatory care and community pharmacists in states with existing testing and treatment authority would see the most direct reimbursement impact; health-system ambulatory clinic pharmacists are the most proximate beneficiaries
• Unresolved questions remain around pharmacist training standards and reimbursement methodology for community health center pharmacists, who operate under a distinct payment model not fully addressed in the current bill language
• Without Medicare provider status, pharmacists authorized by state law to deliver clinical services remain ineligible for federal reimbursement for those same services, a structural gap the bill directly targets

What to Watch

• Track markup activity in the House Energy and Commerce Committee and Senate Finance Committee, both identified as remaining committees of jurisdiction
• Follow Senate progress given Majority Leader Thune’s role as lead Senate sponsor, which improves inclusion in an end-of-year legislative package
• Anticipate private payer policy movement if Medicare recognition is enacted, as commercial insurers frequently align provider contracting with Medicare precedent
• Engage with AMCP and ASHP advocacy channels during the window between now and post-election legislative packaging