Proposed rule · 2026-19535

Request for Information; Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards

This request for information (RFI) solicits input from interested parties for purposes of establishing standards for reasonable and relevant pharmacy contract terms and conditions under the Medicare prescription drug benefit. Section 6223(a) of the Consolidated Appropriations Act, 2026 (CAA, 2026) amends section 1860D- 4(b)(1)(A) of the Social Security Act (the Act) to require Part D plan sponsors to permit any pharmacy that meets standard contract terms and conditions under the plan to participate as a network pharmacy of the plan. Section 6223(a) of the CAA, 2026 further requires that, notwithstanding any other provision of law, for plan years beginning January 1, 2029, such standard contract terms and conditions offered by Part D plan sponsors must be reasonable and relevant according to standards established by the Secretary of the Department of Health and Human Services. Finally, section 6223(a) of the CAA, 2026 requires the Secretary to issue this RFI for purposes of establishing such standards.