Drug pricing policy could jeopardize long-term care pharmacies, leaders contend

DATE: September 24, 2025

By Kimberly Bonvissuto
McKnights Senior Living

Senior living and care leaders have joined a coalition calling attention to a policy fix they say would address unintended consequences of Medicare Part D price negotiations that could shutter long-term care pharmacies. 

The American Health Care Association / National Center for Assisted Living, Argentum and LeadingAge, along with the Senior Care Pharmacy Coalition, are urging passage of HR 5031, the Preserving Patient Access to Long-Term Care Pharmacies Act.

In a Sept. 4 letter to US Department of Health and Human Services Sec. Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Mehmet Oz, the coalition called beneficiary access to long-term care pharmacy services an “existential issue” that could have a significant effect on senior living communities, residents and care coordination.

The SCPC made the letter public on Monday.

The Jan. 1 rollout of new prices for brand-name drugs under Medicare Part D “poses a real threat” to residents and the communities within which they reside, the leaders stated. Long-term care pharmacies rely almost exclusively on Medicare Part D, according to the SCPC, and long-term care residents use eight of the first 10 drugs subject to negotiated prices. 

According to the group, more than 5 million Medicare beneficiaries require long-term care, with 25% living in assisted living communities, skilled nursing facilities, nursing homes or intermediate care facilities that depend on long-term care pharmacies for coordinated medication management.

But those long-term care pharmacies face “untenable” reimbursement gaps as a result of Medicare Part D price negotiations, according to SCPC, which could jeopardize resident safety, access to medications and compliance for senior living communities and other long-term care residential settings.

“We cannot risk our long-term care pharmacies failing,” the letter read, recommending that CMS address the issue through a demonstration project or waiver program, and also supporting the proposed legislation. 

The act would establish a $30 supplemental supply fee for drugs subject to Medicare price negotiations when dispensed by long-term care pharmacies. Modeled after a similar Medicare Part B supply fee, the proposed payment, if implemented, would help offset “steep financial losses,” ensuring long-term care pharmacies remain viable, according to the coalition. 

“There is no substitute for the legally required services that long-term care pharmacies provide, such as 24/7/365 medication management, patient-specific packaging, consultant services and rigorous quality controls,” SCPC President and CEO Alan Rosenbloom said in a news release. “If long-term care pharmacies close, residents will lose access to lifesaving medicines and facilities will face compliance challenges, putting their services in jeopardy as well.”

Almost 2 million older adults — with an average age of 85 and high levels of chronic illness, functional impairment and healthcare use — call senior living communities home, according to Argentum President and CEO James Balda.

“Critially, this population is also largely non-ambulatory, making access to long-term care pharmacies all the more important, particularly in rural areas,” he said. 

AHCA/NCAL President and CEO Clif Porter called long-term care pharmacies an important part of the continuum of care. LeadingAge President and CEO Katie Smith Sloan added that residents of senior living and care communities often manage multiple chronic conditions and rely on an average of 13 prescription drugs daily.

“Long-term care pharmacies make it possible to deliver safe, high-quality and compassionate care,” Sloan said in a statement.

Read the full article on McKnights Senior Living here