S. 3159 — Preserving Patient Access to Long-Term Care Pharmacies Act

This section requires each Part D prescription drug plan (PDP) sponsor and Medicare Advantage-Part D (MA-PD) plan to pay long-term care pharmacies (i.e., those with specified taxonomy code 3336L0003X) a supply fee of $30 for each specified prescription (i.e., covered Part D drug dispensed at the maximum fair price to an applicable maximum fair price eligible individual) dispensed to an enrollee in plan year 2026, and an indexed amount in 2027; the fee is paid in addition to other reimbursements without reducing them, with civil money penalties of not less than $10,000 per failure. It further directs the Secretary to provide PDP sponsors and MA-PD plans a subsidy equal to aggregate supply fees paid to long-term care pharmacies for plan years 2026 and 2027, within 18 months after the plan year. This section also requires the Government Accountability Office, within 12 months of enactment, to complete a study and report to Congress on the economic sustainability of long-term care pharmacies in Medicare Part D—including analyses of ingredient costs (brand-name and generic), dispensing fees, network compliance costs, and payment changes over the prior five years—and recommendations for a sustainable payment system to ensure beneficiary access, particularly in rural markets.