Seniors’ Access to Critical Medications Act of 2025
HB2484, the Seniors’ Access to Critical Medications Act of 2025, would create a temporary Medicare exception to the physician self-referral prohibition for certain outpatient prescription drugs. The bill allows covered Part D drugs to be dispensed by a physician, a physician in the same group practice, or supervised staff when specific conditions are met, including an ongoing patient relationship, a recent in-person visit, and billing through the physician or group practice. The exception would apply from January 1, 2026 through December 31, 2030.
The bill is designed to make it easier for Medicare beneficiaries to obtain medications through physician practices, including pickup, mail, delivery, or courier service. It also clarifies that the new exception does not change existing Part D program requirements. In addition, the bill directs the Government Accountability Office to study physician-linked pharmacy arrangements and report to Congress within three years on growth patterns, ownership structures, contracting features, conflict-of-interest safeguards, and possible effects on prescribing behavior.
The bill would amend Section 1877 of the Social Security Act, which governs the physician self-referral prohibition (Stark law), by adding a new exception for certain outpatient prescription drugs furnished under Medicare Part D. It would also reduce the Medicare Improvement Fund amount in Section 1898(b)(1) from $1,804,000,000 to $1,786,000,000. The practical effect is to permit more integrated dispensing arrangements in physician practices for a limited period, while preserving existing Part D rules and creating a federal oversight study of how such arrangements operate.
The available voting history suggests generally favorable committee sentiment. The bill was ordered reported by a 38-7 vote, indicating broad support but not unanimity. The title and structure of the bill reflect a patient-access rationale, emphasizing seniors’ access to critical medications and convenience in obtaining prescriptions through physician practices.
The main point of contention is the balance between improving medication access and preventing financial conflicts of interest in physician prescribing and dispensing. Supporters appear to favor allowing integrated dispensing for patients with ongoing care relationships, while critics likely worry that physician-owned or physician-integrated pharmacy arrangements could influence prescribing patterns, increase utilization, or create self-referral incentives. The required GAO study reflects these concerns by specifically examining ownership, integration with drug supply chain participants, administrative fees, disclosures, and potential effects on prescribing decisions.