Advocacy for Pharmacists: Expanding Medicare Coverage in 2026
The American College of Clinical Pharmacy (ACCP) revealed its steady commitment to advocating for pharmacist roles in healthcare with its third-quarter report for 2026, highlighting continued lobbying efforts aimed at expanding Medicare coverage and improving medication therapy management services.
As U.S. healthcare evolves, the role of pharmacists, especially in direct patient care and medication therapy management services (MTMS) under Medicare Part D, remains crucial. ACCP's latest report underscores its unwavering lobbying efforts, maintaining a consistent $144,981 in-house expenditure for the third quarter of 2026. These efforts have focused on discussions with the Agency for Healthcare Research and Quality (AHRQ) about MTMS quality standards and seeking Medicare funding for specialized residency training.
Legislative developments offer potential changes in the landscape for pharmacist services. The introduction of the Ensuring Community Access to Pharmacist Services Act (H.R. 3164) in May 2025 underscores a push to expand Medicare coverage to include pharmacist testing and treatment services. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) released a final rule for Contract Year 2026, which deferred changes to Part D MTMS programs for future discussions. For insurance professionals, understanding these developments is essential as they navigate regulatory compliance and opportunities for expanding healthcare services.
Consistent Lobbying Efforts
The ACCP's consistent lobbying investment reflects strategic efforts to secure enhanced roles for pharmacists in health programs. During the second quarter of 2026, ACCP collaborated with Capitol Advocacy & Government Affairs LLC, which filed a separate $450,000 lobbying report, matching the expenditure from the previous year. This brought the combined lobbying total to $594,981, the same level as in the second quarter of 2025. Notably, John McGlew and Kathy Pham continue to be prominent figures in these advocacy efforts.
| Quarter | In-House | Capitol Advocacy |
|---|---|---|
| Q2 2025 | $144,981 | $450,000 |
| Q2 2026 | $144,981 | $450,000 |
| Q3 2026 | $144,981 | Not Filed |
Implications for the Insurance Sector
For insurance professionals, these advocacy efforts could translate into broader coverage options and adjustments in claims management relating to pharmacist-delivered services. The potential expansion of Medicare benefits to include pharmacist services could lead to increased claims, new risk assessment criteria, and enhanced policy offerings. As CMS defers certain MTMS modifications to future rulemaking, insurance carriers and agencies should stay informed on these developments, as they will impact compliance and market positioning.