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Consolidated Appropriations Act, 2026Section 6223 › Proposal

A plan must admit any pharmacy that meets its standard terms

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6223, Sec. 6223. Written by .

A plan must admit any pharmacy that meets its standard terms

The document says “shallWho acts: prescription drug plan sponsorsHow: statuteSec. 6223 in the PDF
What the document says

“A PDP sponsor offering a prescription drug plan shall permit any pharmacy that meets the standard contract terms and conditions under such plan to participate as a network pharmacy of such plan.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6223

Subsection (a) of section 6223 replaces section 1860D-4(b)(1)(A) of the Social Security Act. A prescription drug plan sponsor must let any pharmacy that meets the plan's standard contract terms and conditions join as a network pharmacy.

What the document actually says

“A PDP sponsor offering a prescription drug plan shall permit any pharmacy that meets the standard contract terms and conditions under such plan to participate as a network pharmacy of such plan.”

Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, Sec. 6223
That sentence, in plain words

A drug plan must let in any pharmacy that meets its standard terms. That pharmacy joins the plan's group.

What this is about

A plan pays more, or only, at pharmacies in its group. A pharmacy shut out loses those customers. This says the plan may not shut out one that meets its terms.

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