This is the legislative story pharmacists have been waiting years for, and on May 21, 2026, it moved further than it ever has before. The House Ways and Means Committee advanced legislation that would formally add pharmacists to the Social Security Act as Medicare providers for the first time in the program’s history.
What the Committee Actually Approved
The House Ways and Means Committee have advanced legislation that would expand Medicare coverage for pharmacist-provided testing and treatment services for common respiratory illnesses. The Main Street Pharmacy Access Act, HR 3164, would allow Medicare Part B to cover pharmacist-provided testing and treatment for influenza, respiratory syncytial virus, and strep throat in states that already authorize pharmacists to provide those services. The bill would also formally add pharmacists to the Social Security Act as providers, with Medicare reimbursement set at 80% of the physician fee schedule.
Bipartisan legislation sponsored by U.S. Rep. Adrian Smith (R-NE) that would allow Medicare beneficiaries to access pharmacist-provided testing and treatment for common respiratory illnesses, including COVID-19, flu, RSV, and strep throat, passed the U.S. House Ways and Means Committee on May 21. “I am grateful a bipartisan group of my colleagues voted yes on this legislation, and I look forward to its passage on the House floor,” said Rep. Smith. The bill currently has 114 cosponsors and must also be approved by the U.S. House Energy and Commerce Committee before heading to the full chamber for action.
This bill has been through several names and several Congresses. It was previously known as the Ensuring Community Access to Pharmacist Services Act, ECAPS, before being renamed the Main Street Pharmacy Access Act. The legislation was reintroduced in May 2025 with lead original cosponsor Rep. Brad Schneider (D-IL), having been introduced in past Congresses without reaching this point. This is the furthest it has ever advanced.
Who Is Lined Up Behind This Bill
The breadth of support is the story here as much as the bill’s text.
More than 190 organizations support the measure, including the American Pharmacists Association, the American Society of Health-System Pharmacists, the American Society of Consultant Pharmacists, the Nebraska Pharmacists Association, CVS Health, Kroger Health, XiFin Inc., and the National Association of Chain Drug Stores, among many others.
The American Society of Health-System Pharmacists applauded the committee’s approval of the legislation, which the organization said would improve seniors’ access to timely care in community settings and help reduce strain across the healthcare system. ASHP said the legislation has been a long-standing advocacy priority for the organization and its pharmacy partners. The American Society of Consultant Pharmacists also commended the vote, noting that most states have already authorized pharmacist-provided services for commercial insurance and Medicaid patients, meaning Medicare has lagged behind, leaving many vulnerable older adults with less access to this care than other Americans.
“Public health in America is about to get stronger thanks to the Main Street Pharmacy Access Act. By expanding access to test-and-treat services through pharmacists, the most accessible healthcare providers, we are creating avenues to keep older adults and those living with disabilities healthy and thriving,” said ASCP. Sue Peschin, President and CEO of the Alliance for Aging Research, added: “Seniors in Medicare are deprived of access to pharmacist-provided services that state laws already allow, because pharmacists are overlooked as eligible healthcare providers in the Social Security Act. This must be fixed. We urge all members of Congress who care about older adults in their districts to vote in favor of this bill.” The CDC recently reported that just 61% of nursing home residents received a flu vaccine during the 2024-25 season.
The retail pharmacy chains, often a complicated stakeholder in pharmacy advocacy, are fully behind this bill too. “This legislation would provide Medicare beneficiary coverage for certain pharmacist services,” said CVS Health Chief Pharmacy Officer Lucille Accetta. Kroger Health President Colleen Lindholz stated: “This vital legislation will expand access to testing and treatment for seniors living in rural areas, managing common respiratory conditions before they become life-threatening. Kroger celebrates this progress and urges quick passage of this bill.” McKesson added its support, stating: “Independent pharmacies are reliable points of care, and this bipartisan legislation helps Medicare beneficiaries receive timely testing and treatment from pharmacists.”
Why the PCMA Endorsement Matters
The most notable signal in this entire story is the position of the trade group representing pharmacy benefit managers, an organization that has been at odds with pharmacy advocacy on nearly every other front in recent years, including the PBM reform legislation covered in earlier issues of this newsletter.
The Pharmaceutical Care Management Association supports the legislation’s objective to expand access to care for seniors by allowing Medicare to reimburse pharmacists for important clinical care services they provide to patients. David Marin, President and CEO of PCMA, stated: “For millions of Americans, a pharmacist is the care provider they most often see and trust, and we should be empowering and properly compensating these health professionals for that care. The bipartisan ECAPS Act recognizes the critical role pharmacists already play in delivering health care services, especially to seniors and patients in rural and underserved communities.”
PCMA’s earlier statement on this legislation noted: “PBMs recognize the critical value of pharmacists in our communities and that especially in rural areas, patients may depend on their pharmacist for more than filling prescriptions. Innovative programs between PBMs and pharmacies provide patients with a higher quality, lower cost pharmacy experience. These include expanding reimbursement for clinical services so patients can receive more care at their local pharmacies.”
When the trade organization representing PBMs, the chains, the independents, the consultant pharmacists, the health-system pharmacists, and the patient advocacy groups all support the same bill, that alignment reflects a policy that has cleared the most common blocking coalitions in healthcare legislation. It does not guarantee passage. It does mean the remaining obstacles are procedural, not political.
The Public Opinion Data That Strengthens the Case
New NACDS/Morning Consult polling shows that 81% of seniors age 65 and older say they are likely to support a Congressional candidate who works to secure Medicare enrollees’ ability to receive tests for flu, strep throat, and RSV, and their respective treatments, from their pharmacists. Support spans party lines, with 80% of conservative adults and 85% of liberal adults backing the policy. Support among Congressional lawmakers for H.R. 3164, and its companion legislation in the Senate, S. 2426, is notable, as more than a quarter of Congress has co-sponsored the legislation in their respective chambers.
A bill with 80 to 85% public support across the political spectrum and over a quarter of Congress already on record as cosponsors is, by the standards of federal legislation, in a strong position. The bipartisan nature of the bill’s sponsorship, a Republican from Nebraska and a Democrat from Illinois as lead sponsors, reflects exactly the kind of coalition that survives committee votes and floor scheduling battles.
Where the Bill Goes from Here
The bill must also be approved by the U.S. House Energy and Commerce Committee before heading to the full chamber for action.
That second committee step is the next hurdle. Energy and Commerce shares jurisdiction over Medicare policy with Ways and Means, and bills affecting the Social Security Act and Medicare Part B coverage frequently require sign-off from both committees before reaching the House floor. The Ways and Means approval is necessary but not sufficient.
This newsletter has covered the PBM Reform Act’s path to becoming law earlier this year, and the parallel is instructive. When the Consolidated Appropriations Act of 2026 was signed into law in February, HR 3164 was notably not included, despite years of advocacy. APhA’s Ilisa Bernstein Hogue stated at the time: “While these reforms begin to address one of the most significant challenges pharmacists face under Medicare, they represent one part of the broader effort needed to strengthen pharmacy access and fully support patient care. To truly improve health care delivery, Congress and Medicare must also now recognize and pay for the patient care services that pharmacists provide every day.”
This Committee passage represents the closest HR 3164 has come to floor consideration on its own merits, separate from being attached to a larger appropriations vehicle that may or may not include it.
What Provider Status Would Actually Mean If Enacted
The bill would formally add pharmacists to the Social Security Act as providers, with Medicare reimbursement set at 80% of the physician fee schedule, and would allow Medicare Part B to cover pharmacist-provided testing and treatment for influenza, RSV, and strep throat in states that already authorize pharmacists to provide those services.
The scope is narrower than full provider status across all clinical services. This bill specifically targets test-and-treat services for three common respiratory illnesses, plus COVID-19. But the legal mechanism, formally adding pharmacists to the Social Security Act, is the structural breakthrough. Once pharmacists exist as a recognized provider category under the Social Security Act for any service, the legislative pathway for expanding that recognition to additional services, including the comprehensive medication management, MTM, and chronic disease management services covered throughout this newsletter, becomes substantially more direct.
This is the foot in the door that the profession has been advocating for since before this newsletter began publishing. Every state-level provider status win covered in prior issues built toward this moment. The broader healthcare environment, including FDA leadership transitions and CDC capacity issues covered in earlier newsletters, makes the timing of this legislative momentum notable. Federal health policy attention is fragmented across multiple crises, which makes bipartisan, broadly supported, narrowly scoped legislation like HR 3164 more likely to move through committee successfully than more contentious or sweeping reforms.
Your Action This Week
The bill must clear the House Energy and Commerce Committee before reaching the full House floor. That committee process is happening now, and constituent contact during this window carries genuine weight.
Contact your representative’s office, particularly if they sit on the House Energy and Commerce Committee, and reference HR 3164, the Main Street Pharmacy Access Act, by name. A two-minute phone call or email is sufficient. Identify yourself as a licensed pharmacist or pharmacy owner in their district, state that you support HR 3164, and ask them to support its advancement through committee and to the House floor.
If your representative is already among the 114 cosponsors, a brief thank-you message reinforces that the issue matters to constituents and supports continued advocacy from their office.
Operationally, if your pharmacy does not yet hold a CLIA certificate for point-of-care testing, begin that process now. In eligible states, this legislation means seniors can receive the care they need close to home and turn to their neighborhood pharmacist as a first point of care. If HR 3164 reaches the House floor and passes, with Senate companion S. 2426 already introduced, the pharmacies that hold CLIA certification, have established collaborative practice agreements where required by state law, and have billing infrastructure ready will be positioned to bill for these services from the moment the law takes effect.
This bill has traveled further in 2026 than in any prior Congress. The coalition behind it spans organizations that rarely agree. The public support is overwhelming and bipartisan. The structural change it would create, pharmacists formally recognized under the Social Security Act, is the foundation the profession has been building toward for years.
The next committee vote matters. Make the call.
Sources: Becker’s Hospital Review (House Panel Advances Pharmacist Medicare Access Bill, May 21, 2026), PharmiWeb / ACCESS Newswire (ASCP Commends Congressional Action to Expand Medicare Access to Pharmacist Services, May 21, 2026), NACDS (NACDS Applauds House Ways and Means Committee Passage of Main Street Pharmacy Access Act, May 21, 2026), Chain Drug Review (NACDS Praises House Ways and Means Committee Passage of Main Street Pharmacy Act), Drug Store News (Pharmacy Orgs Commend House Committee on Ways and Means for Passage of Main Street Pharmacy Access Act), Ripon Advance (Smith’s Pharmacy Access Bill Passes Ways and Means Committee, May 21, 2026), NCPA (Pharmacy Bills to Be Marked Up in House Committees Today, May 21, 2026), House Ways and Means Committee (Markup Notice, HR 3164, May 21, 2026), Representative Adrian Smith’s Office (What They Are Saying: Smith’s Main Street Pharmacy Access Act Clears Ways and Means Committee), PCMA (PCMA Supports Bipartisan ECAPS Act to Expand Access to Care and Strengthen Role of Pharmacists), AMCP (Issue Brief: Ensuring Community Access to Pharmacist Services Act), Pharmacy Times (PBM Reform Within 2026 Appropriations Bill Signed Into Law), Congress.gov (HR 3164, 119th Congress)
