Medicare doctors could dispense drugs in-office under five-year Stark Law waiver

What does this do?

HR 2484 creates a temporary exception to the Stark Law, allowing doctors and medical group practices to dispense certain Medicare Part D prescription drugs directly from their offices and bill Medicare for them between January 1, 2026, and December 31, 2030. To qualify, patients must have an existing relationship with the doctor and at least one in-person visit with that practice in the past year, and the prescribing and dispensing must be done by the same doctor or practice. Medications can be picked up in person or received by mail or delivery.

Who does it affect?

Medicare beneficiaries, primarily Americans aged 65 and older or people with certain disabilities, are directly affected as potential recipients of in-office dispensed drugs. Doctors and medical group practices that choose to dispense medications in-house would also be significantly affected, gaining a new way to provide and bill for prescription drugs under Medicare.

Why does it matter?

The Government Accountability Office (GAO) is required to study and report to Congress within three years on how physician offices are integrating drug dispensing, in order to monitor whether the exception leads to unusual prescribing patterns or potential conflicts of interest. The bill also reduces a Medicare improvement fund by $18 million, likely to help offset costs.

What does it cost, and who pays?

• Medicare improvement fund cut
• $18 million reduction
• Offsets new exception costs

Where does it stand?