Long-Term Care Pharmacy Definition Act of 2021

Long-Term Care Pharmacy Definition Act of 2021

This bill establishes a statutory definition for long-term care pharmacy under the Medicare prescription drug benefit.

Currently, there is no statutory definition. Regulations from the Centers for Medicare & Medicaid Services (CMS) define a long-term care pharmacy as a pharmacy that is owned by or under contract with a long-term care facility to provide prescription drugs to the facility's residents. Additional requirements are set out in CMS guidance relating to the Medicare prescription drug benefit; pharmacies are also subject to regulations and guidance from other agencies (e.g., packaging requirements from the Food and Drug Administration).    

The bill defines a long-term care pharmacy as a state-licensed pharmacy that is able to provide enhanced pharmacy and clinical services to individuals who have certain comorbid and medically complex chronic conditions and who reside in skilled nursing facilities, nursing facilities, or any other applicable setting (as determined by the CMS). The term enhanced pharmacy and clinical services includes medication dispensed in special packaging, drug utilization review, and 24-7 availability of medication delivery and on-call pharmacists.