Seniors’ Access to Critical Medications Act of 2024

Mr. Speaker, I rise today in strong support of H.R. 5526, the Seniors' Access to Critical Medications Act.

I thank my co-lead, Democrat Representative Wasserman Schultz, and House Energy and Commerce Chair Rodgers and Ranking Member Pallone for allowing me to advance this important legislation.

I spent 37 years working as a pharmacist in almost every area of pharmacy, and I know firsthand the importance of providing patients with serious illnesses timely and reliable access to their lifesaving medications.

Under the Centers for Medicare and Medicaid Services' interpretation of the physician self-referral law, which is known as the Stark Law, it states that it is unlawful for a medical practice, such as a community oncology practice, to deliver a prescribed and filled drug to a patient by mail or courier, UPS or Fed Ex. CMS' interpretation doesn't even allow for a family member or a caregiver to pick up the patient's drug on their behalf.

For Medicare seniors living in rural areas who don't have transportation or who are too sick to pick up their lifesaving drug, they are just simply out of luck in a lot of cases, or they are forced to rely on a nameless or faceless mail order pharmacy benefit manager, where these ``distant middlemen'' cannot quickly fine-tune necessary short-term changes or adjustments in their therapies.

Some patients will go without their oral chemotherapy medication because they can't get transportation to pick their prescription up. It can change the entire outcome for those patients. We shouldn't have obstacles in the way of patients receiving the medications they need.

The bipartisan Seniors' Access to Critical Medications Act simply ensures that cancer patients, as well as other patients, have timely access to the appropriate oral medications they need by allowing delivery of these medications or allowing family members or caregivers to pick up their medicines.

I have heard from dozens upon dozens of Tennessee oncologists and other specialty physicians and patients, as well as others around the country, who have been deeply impacted by the unnecessary hurdles created by CMS' misguided interpretation of the Stark Law.

During the pandemic, CMS recognized these barriers and issued a Stark waiver, lifting the restrictions that hindered patient access to these crucial medications.

This bill restores those flexibilities, and I urge all my colleagues to support H.R. 5526 to protect Medicare beneficiaries' ability to receive the medications they need when they need them.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5526) to amend title XVIII of the Social Security Act to clarify the application of the in-office ancillary services exception to the physician self-referral prohibition for drugs furnished under the Medicare program, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, a silver lining of the COVID-19 pandemic, if there is one, was the proliferation of new, effective ways to deliver healthcare.

Of course, we saw the rise of telehealth, but we also saw an increased use of mail to deliver prescription drugs to patients. Mailing prescription drugs to patients, especially those who live in rural communities, helped increase access to care and medication adherence by reducing the need to travel long distances to your nearest pharmacy.

For seniors who may struggle with mobility, this change was especially important.

Unfortunately, Federal laws limit the ability for seniors to take advantage of these benefits.

CMS states that if a Medicare beneficiary wants to see an independent physician that also owns a pharmacy, the Medicare beneficiary must pick up their drugs from that physician-owned pharmacy in person.

That pharmacy cannot mail the drug directly to the patient or let a family member pick up the drug on the Medicare patient's behalf.

During the COVID-19 pandemic, CMS relaxed this restriction. I have heard from countless oncologists across my home State about how during the COVID-19 pandemic era, those flexibilities improved access to care.

H.R. 5526 would clarify that seniors can get drugs from physician- owned pharmacies through the mail or have someone pick up those medications on their behalf, making it easier for seniors to get the care that they need.

I encourage my colleagues to support this bill, and I reserve the balance of my time.

Mr. Speaker, I yield 5 minutes to the gentlewoman from Tennessee (Mrs. Harshbarger).

Mr. Speaker, in closing, I encourage a ``yes'' vote on this bill, and I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 5526, the Seniors' Access to Critical Medications Act.

This bill amends the Physician Self-Referral Law, also known as the Stark Law, to permit Medicare patients to have their physicians dispense prescription drugs to them in narrow circumstances, either through a caregiver or through a mail courier. Congress enacted the Stark Law to ensure that physician financial considerations do not influence patient care. Under the Stark Law, physicians are prohibited from making referrals to entities in which the physician has a financial stake.

Medicare beneficiaries deserve the independent judgment of their physicians and access to treatment that is medically appropriate and necessary for them. The Stark Law is critical in ensuring that financial arrangements do not distort physician decisionmaking or raise healthcare costs.

Now, current law includes specific and narrowly tailored exceptions such as the in-office ancillary services exception. This exception permits a physician with an ownership stake to provide an outpatient prescription drug or certain services to a patient at his or her office as part of an in-person visit. This is for the convenience of the patient but also because there are more limited program integrity concerns when the item or service is being delivered as part of an in- person office visit.

While I continue to have strong concerns with significantly weakening the Stark Law, I believe there are also limited instances in which it may be necessary for a caregiver or a family member to pick up the prescription drugs for patients or for them to be mailed. I believe there are limited program integrity concerns in these instances.

This narrow Stark exception will help patients receive necessary medications more easily and protects Medicare beneficiaries by ensuring that financial considerations do not influence patient care.

I urge my colleagues to join me in voting ``yes'' on H.R. 5526, and I reserve the balance of my time, Mr. Speaker.

Mr. Speaker, I support this legislation and urge its passage, and I yield back the balance of my time.