Letter to the Editor: Inquirer readers on billing by long-term care pharmacies

DATE: December 11, 2025

By Rob Franklin | Published December 11, 2025 in The Philadelphia Enquirer

Well-meaning policy

If you walk into any nursing home in the southeastern corner of the commonwealth, you’ll find a highly choreographed system of long-term care (LTC) pharmacies humming along that help keep older Pennsylvanians safe and are the backbone of patient care.

But this system is just months away from a potential collapse. Unless the Trump administration or Congress takes action now, on Jan. 1, a new policy will devastate LTC pharmacies that serve senior living facilities and nursing homes.

Passed during the Biden administration, the Inflation Reduction Act allowed the federal government to negotiate with drug companies to determine “maximum fair prices” on certain expensive brand-name drugs for Medicare Part D beneficiaries — a policy designed to help seniors afford medications.

But there’s a problem: The law is about to bankrupt the very pharmacies these seniors depend on to stay alive.

By setting “maximum fair prices” on certain brand-name drugs, the policy significantly reduces the reimbursement rates LTC pharmacies receive.

This price change will have rippling effects on all facilities that depend on the services of LTC pharmacies, including the 200,000 Medicare Part D beneficiaries over age 65 who have long-term care needs.

The Trump administration can act via an executive order to keep LTC pharmacies operational by delaying or modifying the new drug pricing until a sustainable payment model is identified.

Simultaneously, Congress must pass the bipartisan Preserving Patient Access to Long-Term Care Pharmacies Act (HR 5031). This legislation would establish a temporary $30 supply fee for each prescription filled under the new negotiated prices — a modest investment that would keep pharmacies solvent through 2027.

We can’t afford to look the other way — our seniors deserve a system that supports them, not one that collapses under the weight of well-meaning policy.

Read the full article on The Philadelphia Enquirer here