HR 5031 Passage Crucial for Seniors’ Drug Access

AHCA/NCAL, LeadingAge, and Argentum Press For Congress to Pass the HR5031 Act

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL), LeadingAge, and Argentum are urging Congress to pass the Preserving Patient Access to Long-Term Care Pharmacies Act (HR5031), as announced in a recent press release.¹

What is the HR5031 Act?

The Senior Care Pharmacy Coalition (SCPC) previously praised HR 5031, describing it as an act designed to introduce a new supply fee to continue government-mandated services for long-term care (LTC) pharmacies. This is in anticipation of new Medicare negotiated prices on certain drugs (MFP) slated to take effect from January 1, 2026.²

Filling the Gaps in Healthcare Services

The increasing need for medication among the senior population in LTC settings necessitates the involvement of AHCA/NCAL, LeadingAge, and Argentum, who are notable advocates for providers within LTC facilities like nursing homes and assisted living. They are all working to ensure that seniors’ access to crucial medications remains unaffected despite the forthcoming legislation set to take effect in 2026.¹

The HR 5031 bill aims to bridge any existing gaps between the care communities where seniors live and the LTC pharmacies that dispense these medications. With over 5 million Medicare beneficiaries requiring LTC and 25% of them occupying assisted living settings, HR 5031 proposes a $30 supply fee paid to LTC pharmacies on each MDPNP drug dispensed. This is geared at alleviating the pressure on seniors’ access to medication, which is set to change at the beginning of 2026 when the Medicare Drug Price Negotiation Program (MDPNP) is officially rolled out.¹

Concerns Regarding the MDPNP

However, Douglas Hoey, RPh, MBA, CEO of the National Community Pharmacists Association (NCPA), voiced concerns about the MDPNP. He said, “The program is structured in a way that will force many independent pharmacies out of the Medicare Part D program…Seniors will be stranded without a pharmacy, and they won’t get the benefit of lower drug prices.”³

Potential Impacts of the Inflation Reduction Act (IRA) of 2022

Further concerns are centered on the potential fallout from the Inflation Reduction Act (IRA) of 2022, which could lead to the closure of several pharmacies post-January 1, 2026. The IRA, in collaboration with the Centers for Medicare & Medicaid Services, formulated a plan with drugmakers to limit the price of specific medications for Medicare Part D beneficiaries.⁴

While the IRA legislation and MDPNP initiative were designed to significantly decrease patients’ out-of-pocket (OOP) spend, the reception among various stakeholders in the pharmacy industry is waning.

Future of LTC Pharmacies

HR 5031, which has received bipartisan support from six congressmen, offers a feasible solution for LTC pharmacies that may face financial constraints once MDPNP drugs are enacted next year. It proposes a $30 supply fee paid to LTC pharmacies for each MDPNP drug dispensed, offsetting the potential losses these pharmacies may experience following the drug price changes.¹

According to the SCPC release, LTC pharmacies depend almost exclusively on Medicare Part D drug plans. Patients in LTC facilities frequently use at least 8 of the first 10 drugs that were selected for drug price negotiations in 2026. Advocates for LTC and pharmacy-based areas are exploring methods to mitigate the impact of the MDPNP, including solutions like HR 5031.

Protecting Senior Care

The authors of the release conclude, “If LTC pharmacies close, residents will lose access to lifesaving medicines and facilities will face compliance challenges, putting their services in jeopardy as well. Congress must act swiftly to pass HR 5031 to save senior care.”¹