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Something unusual is happening in Washington. The administration has spent 2026 leaning publicly on pharmacists as accessible frontline providers, from expanded roles in medication management to being named as the logical point of contact for patients navigating complex therapy. HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz have both framed pharmacists as an underused answer to an access problem the rest of the system cannot solve alone. Neither is arguing for this bill by name, but the direction of the rhetoric is consistent. Set the politics aside and the practical signal is clear: the federal posture toward pharmacist-delivered care is shifting from tolerance to encouragement.

Over the past decade, a patchwork of state laws has steadily expanded what pharmacists can do. Test-to-treat authority for respiratory illnesses like influenza, strep, and RSV now exists in much of the country. Prescriptive authority for tobacco cessation, hormonal contraception, and other protocolized services has spread state by state, though the scope varies widely from one border to the next.

In one state a pharmacist can screen a patient, order a test, and prescribe a treatment in a single visit. Cross a state line and the same pharmacist, with the same license and training, cannot. Care delivery should not depend on which side of a line a patient happens to live on.

Here is the structural problem underneath the patchwork. Even where state law authorizes a pharmacist to deliver a service, Medicare frequently will not pay for it, because pharmacists are not recognized as providers under the Social Security Act. That single omission means seniors, the population most dependent on accessible local care and prescription medications, often have less access to pharmacist services than patients with commercial insurance or Medicaid, who in most states already have it.

That definition is now moving. On May 21, 2026, the House Ways and Means Committee advanced the Main Street Pharmacy Access Act (H.R. 3164), formerly the Ensuring Community Access to Pharmacist Services Act. The bill was reintroduced by Rep. Adrian Smith (R-Neb.) and Rep. Brad Schneider (D-Ill.), a pairing that held through markup. The bill would establish Medicare Part B coverage for pharmacist-administered testing and treatment of influenza, RSV, strep throat, and COVID-19, in states that already authorize those services. It would formally recognize pharmacists as providers under Medicare for these services, and it would reimburse them at 80 percent of the Physician Fee Schedule, which means it expands access while costing Medicare less per service than the physician equivalent.

A companion bill, S. 2426, has bipartisan sponsors in the Senate as well, Majority Leader John Thune (R-S.D.) and Elizabeth Warren (D-Mass.), an unusual pairing that underscores how little this issue splits along party lines.

Two details matter most to the AMA and its physician allies, who sent a formal letter opposing the bill on patient-safety and scope-of-practice grounds. The bill does not preempt state scope-of-practice law, so it expands billing only where a state has already granted the underlying authority. And it drew bipartisan support alongside genuine debate, including scope-of-practice concerns raised by Rep. Greg Murphy (R-N.C.), a urologist on the committee, who also flagged worries about the pressure vertically integrated pharmacy chains might put on pharmacists to expand their clinical role.

Pharmacies that already have test-to-treat workflows in place, documented clinical protocols, and staff trained on billing, will be positioned to start capturing this reimbursement the moment the bill is signed. Waiting until after passage to build that infrastructure means a slower ramp while competitors who prepared now already have patients in the door.

The trajectory is unmistakable. State authority has been building for a decade, the federal posture has turned favorable, and a bipartisan bill to make Medicare pay for pharmacist care has cleared committee and is headed for a House floor vote. This is the moment the profession has argued toward for years. The state patchwork is slowly becoming a federal floor, and the difference between momentum and law is advocacy that does not let up now. If you are a pharmacist or pharmacy owner, this is the bill to call your representative about. Tell me what you are seeing in your state, and whether your delegation is on record.

The Case for Paying Pharmacists to Practice

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