Drug prices & Part D
CMS Asks the Public to Help Define Fair Pharmacy Contract Terms for Medicare Drug Plans
A 2026 federal spending law will require Medicare Part D plans to accept any pharmacy that agrees to standard contract terms starting in 2029. A new request for information is the first step toward writing those standards.
By the Goodsurance editorial teamSeptember 26, 2026
The Centers for Medicare and Medicaid Services published a request for information on September 24 asking pharmacists, health plans, beneficiary advocates, and members of the public to help shape regulations that will determine which pharmacies must be allowed to join Medicare Part D prescription drug plan networks.
The request follows from Section 6223(a) of the Consolidated Appropriations Act of 2026, which amended federal law to require all Part D plan sponsors to accept any pharmacy that agrees to the plan's standard contract terms and conditions. The provision takes effect for plan years beginning January 1, 2029. CMS must publish final standards by the first Monday in April 2028.
By 2029, Medicare Part D plans may have to let in more pharmacies. CMS is taking public comments on what fair contract terms should look like. Deadline: November 23.
Currently, Part D plan sponsors can restrict their pharmacy networks, which can lead to the exclusion of independent, rural, or specialty pharmacies. If the forthcoming standards establish a baseline below which plans cannot go, pharmacies willing to meet those terms would gain a right to participate, potentially expanding where beneficiaries can fill prescriptions and how much they pay out of pocket.
CMS is seeking input on which current program guidance may need updating, which contract terms most affect whether a pharmacy chooses to participate, and how to balance plan design flexibility against beneficiary access.
Interested parties have until November 23, 2026, to submit written comments.
In plain words
Right now, Medicare drug plans can leave out some pharmacies from their networks. A new law says that by 2029 any pharmacy that agrees to standard contract terms must be let in. The government is asking the public to help decide what those terms should say. This could mean more pharmacies near you would accept your Medicare drug plan. You can send comments until November 23, 2026.
Understand the basics first
Source: Federal Register
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