Temporary supply fee for long-term care pharmacies called ‘essential’

DATE: November 12, 2025

By Kimberly Bonvissuto | Published November 12, 2025 in McKnight’s Senior Living

A supply fee for drugs subject to Medicare Part D price negotiations is being touted as “essential” to the sustainability of long-term care pharmacies that serve assisted living communities and nursing homes.

Sen. James Lankford (R-OK) and Sen. Markwayne Mullin (R-OK) introduced S 3159, the Senate companion to HR 5301, the Preserving Patient Access to Long-Term Care Pharmacies Act on Monday. The bill in 2026 and 2027 would provide $30 supply fees for certain drugs to long-term care pharmacies that rely on Medicare Part D for 75% of their revenue.

Beginning in 2026, several medications used in long-term care facilities will be subject to new Medicare pricing rules. Without this fix, long-term care pharmacies would be “devastated” by Medicare Part D price negotiations taking effect Jan. 1, 2026, according to the Senior Care Pharmacy Coalition.

Long-term care pharmacies, according to the SCPC, do not have front-of-store sales to offset losses and must meet strict federal requirements, including 24-hour delivery, emergency access, specialized packaging and on-site clinical support.

LeadingAge, Argentum and the American Health Care Association / National Center for Assisted Living back S 3159.

LeadingAge said the bill addresses an “imminent need.”

“Assisted living providers that rely on long-term care pharmacies must be able to count on the financial stability of these pharmacies to ensure residents do not lose access to critical medications,” LeadingAge Senior Vice President of Policy Linda Couch told McKnight’s Senior Living. 

The American Seniors Housing Association also said that it supports efforts to ensure access to essential medications and pharmacy services, adding that “keeping these pharmacies operational is really important to the communities and residents they serve.”

A new SCPC white paper, with analytics by ATI Advisory, found that Medicare drug price negotiations will reduce long-term care pharmacy operating margins by 35% in 2027, leaving the average pharmacy operating at an almost 3% loss.

AHCA/NCAL, Argentum and LeadingAge, along with the SCPC, sent a joint letter in September to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services urging passage of HR 5031. 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.

Read the full article on McKnight’s Senior Living here