Senator James Lankford (R-OK) on November 7, 2025, introduced S 3159, the “Preserving Patient Access to Long-Term Care Pharmacies Act,” which seeks to address financial challenges long-term care pharmacies will face as the Inflation Reduction Act’s Medicare drug price negotiations drive down their revenues.
LeadingAge supports this bill, as well as its House companion, HR 5031, introduced in August.
Long-term care pharmacies provide crucial medication management and clinical services for residents in long-term care settings such as nursing homes, assisted living facilities, skilled nursing facilities (SNF), hospices and rehabilitation facilities.
Importantly, these pharmacies are not open to the public and do not sell additional consumer goods and focus exclusively on dispensing prescriptions.
However, long-term care pharmacies are in jeopardy as a downstream unintended consequence of the Inflation Reduction Act. There is a real concern that these pharmacies may face closure, impacting both providers and individuals who rely upon them for medication services.
The bills would provide temporary supply fees for long-term care pharmacies, requiring prescription drug plans and Medicare Advantage (MA) organizations to pay $30 per prescription in plan year 2026, with subsequent increases in plan year 2027, including the supply fee for the prior plan year which would be increased by the annual percentage increase. The bills clarify that the supply fee is to be paid at the same time and in addition to any other pharmacy reimbursements, including ingredient costs, dispensing fees, or other payments negotiated between the PDP sponsor or MA organization and the long-term care pharmacy, with no resulting reductions to other reimbursements. The bills also set other requirements including enforcement functions and civil monetary penalties for Medicare Advantage organizations that fail to pay the supply fee for a specified prescription dispensed to an enrollee in an amount of not less than $10,000, and they mandate that plan sponsors repay the fees through subsidies provided by the Secretary within 18 months of the plan year ending. The bills also require that the U.S. Government Accountability Office conduct a study on the economic sustainability of long-term care pharmacy participation with recommendations for a sustainable payment system ensuring access, especially in rural areas.
