Bill > S4106

This bill, also known as the Rx Access, Choice, Cost Equity, and Supply Stability Act (Rx ACCESS Act), aims to improve access to medications for individuals covered by TRICARE, the healthcare program for U.S. military personnel and their families. Specifically, it allows eligible beneficiaries to choose how they receive non-generic maintenance medications starting October 1, 2026, and establishes new standards for how Pharmacy Benefit Managers (PBMs), companies that manage prescription drug benefits, are reimbursed by the Department of Defense. Under these new standards, retail pharmacies must be reimbursed at least their actual acquisition cost for a drug plus a professional dispensing fee equivalent to what the state pays under Medicaid (a government health insurance program for low-income individuals). The bill also prohibits PBMs from charging retail pharmacies hidden or retroactive fees and mandates annual audits by the Comptroller General of the United States to review reimbursement rates, pharmacy network adequacy, and beneficiary access, with reports submitted to Congress. The Secretary of Defense is required to submit a plan for implementing these changes within 90 days of the bill's enactment.

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https://www.congress.gov/bill/119th-congress/senate-bill/4106/all-info