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HealthH.R. 2484Not Yet VotedComments

Seniors’ Access to Critical Medications Act of 2025

Official title: To amend title XVIII of the Social Security Act to establish an exception to the physician self-referral prohibition for certain outpatient prescription drugs furnished by a physician practice under the Medicare program.

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What Happened in Congress?

Pending

Not yet voted on the floor.

Where the Bill Stands

  1. Introduced, done
  2. Committee, done
  3. Floor Vote, current stage
  4. Outcome, not yet

What This Bill Does

This bill temporarily expands flexibilities under the Stark law (i.e., the Physician Self-Referral Law) for certain physicians who dispense covered outpatient drugs under the Medicare prescription drug benefit at the physician's office location (e.g., through an integrated pharmacy). The Stark law generally prohibits physicians from referring patients to receive services that are payable under Medicare or Medicaid from entities in which the physician or an immediate family member has a financial relationship.

Specifically, the bill allows, from 2026-2030, physicians to dispense such drugs from the physician's office, including through in-person pickup by a caregiver or via mail, if (1) the physician prescribed the drug, (2) the beneficiary has an ongoing relationship with the physician, (3) the beneficiary had at least one face-to-face visit with the physician in the prior year, and (4) the physician bills for the drug. These requirements also apply to physicians within the same group practice.

The Government Accountability Office must report on pharmacies or pharmacy networks that dispense significantly more covered drugs under the Medicare prescription drug benefit after the bill's enactment, the extent to which such pharmacies and networks are owned by physicians or integrated into physician practices, and the common characteristics of these types of arrangements.

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Timeline

  1. House committee actionsCommittee Consideration and Mark-up Session Held
  2. Library of CongressIntroduced in House
  3. House floor actionsReferred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  4. Introduced
  5. Committee

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