Pharmacy and Medically Underserved Areas Enhancement Act Offers New Hope

In September 2025, Sen Chuck Grassley (R, Iowa) and Sen Ben Ray Luján (D, New Mexico) reintroduced the Pharmacy and Medically Underserved Areas Enhancement Act (S 2800). This legislation seeks to amend the Social Security Act to provide Medicare reimbursement for pharmacist services in rural and underserved areas. Services would include, but are not limited to, health and wellness screenings, immunizations, management of chronic diseases including diabetes, comprehensive medication management, tobacco cessation aid prescribing, and administration of common tests such as influenza and streptococcal pharyngitis.^1,2

If passed into law, the act would require the secretary of the US Department of Health and Human Services to develop a list of pharmacist-specific billing codes under the physician fee schedule of the Social Security Act. Reimbursement to a pharmacist would be at a reduced level from the reimbursement that would otherwise be paid to a physician performing the clinical services.

The act seeks to leverage the data that 90% of the US population lives within 5 miles of a community pharmacy, and this can substantially enhance access to health care.² Without the ability of pharmacists to be compensated for clinical services, patients often travel great distances to receive the same services from physicians. In addition, pharmacies in rural and underserved areas are often economically disadvantaged due to their reduced bargaining power with pharmacy benefit managers.

Pharmacists have been able to indirectly receive reimbursement for these services; however, they must be conducted in direct collaboration with a physician and often through collaborative practice agreements. This legislation seeks to reduce the red tape involved by providing a direct pathway for pharmacist reimbursement.

The act has been introduced in previous years and in the previous congressional session. However, it has been unsuccessful in progressing to the floor of both chambers for a vote. Senators Grassley and Lujan expressed optimism that this version of the act will be more successful.²

REFERENCES

1. Pharmacy and Medically Underserved Areas Enhancement Act, S 2800, 119th Cong (2025-2026). Accessed October 2025. https://www.congress.gov/bill/119th-congress/senate-bill/2800/text

2. Request for information on pharmacists providing chronic care. Senator Chuck Grassley. Accessed October 20, 2025. https://www.grassley.senate.gov/imo/media/doc/request-for-information_on_pharmacists_providing_chronic_care.pdf