Long-term care pharmacies are carrying the weight of a service model that the reimbursement system no longer supports. They’re required to operate 24/7, dispense in shorter and shorter cycles, manage complex polypharmacy, deliver urgently, provide additional clinical and administrative services, and utilize expensive specialized compliance packaging—yet reimbursement for this sector still mirrors retail pharmacy economics.

A long-awaited overhaul of the LTC pharmacy payment model is critically needed, but the timeline is stretching months—or more—into the future. In the meantime, the pressure on pharmacies is becoming unsustainable. Without intervention, the stability of medication access in senior care settings is at risk.

A temporary supply fee has been proposed as a bridge—an immediate, short-term fix designed to keep LTC pharmacies operational while federal reforms can be negotiated. Industry groups emphasize that this fee is essential to prevent service disruptions that could compromise resident safety and clinical outcomes.

Why the Temporary Supply Fee Is Urgently Needed

• Unfunded Services: LTC pharmacies provide time-intensive, labor-heavy services—emergency delivery, rapid turnaround, med-pass support, costly compliance packaging cycles, medication coordination and documentation, and specialized clinical services—without reimbursement aligned to actual cost.
• Operational Strain: Provisions from the Inflation Reduction Act that cap Medicare drug prices for certain medications go into effect on January 1, 2026, which will result in revenue shortfalls that create unsustainable losses for virtually all LTC pharmacies. On top of that, inflationary pressures and staffing shortages continue to escalate expenses.
• Regulatory Complexity: Pharmacies’ compliance with extensive CMS, DEA, FDA, OSHA, and state regulations is complex, expensive, and labor-intensive.
• Risk to Residents: Any reduction in LTC pharmacy viability threatens timely access to critical medications, emergency fills, and accurate medication management—particularly for high-acuity residents.

National advocates—including LeadingAge, AHCA/NCAL, Argentum, and the Senior Care Pharmacy Coalition (SCPC)—continue to emphasize that immediate relief is essential to stabilize LTC pharmacy operations while CMS works toward a longer-term payment overhaul. Federal officials acknowledged the challenges in the CMS meeting transcript. They also note the ongoing work to redesign LTC pharmacy payments in the CMS rulemaking summary.

Until that overhaul is complete, a temporary supply fee is the only practical safeguard against pharmacy instability.

What You Should Do Now

Your voice carries weight because you see the consequences when pharmacy systems are strained. Help drive urgent action by:

• Contacting your federal legislators to express support for a temporary LTC pharmacy supply fee
• Sharing real-world operational impacts (delays, med-pass strain, emergency fills, high-acuity needs)
• Highlighting the importance of 24/7 pharmacy access to survey readiness and resident safety
• Engaging your trade associations to amplify and accelerate advocacy
  

This is a moment where inaction could lead to diminished pharmacy readiness and compromised care. A temporary supply fee is not optional—it’s essential.

Forum Is Here to Support You

Forum has delivered dependable, LTC-focused pharmacy care for more than 50 years. Our teams maintain the accuracy, safety, and around-the-clock reliability that senior care depends on—and we’re committed to helping your community navigate this evolving policy landscape.

If you’d like help communicating with policymakers or educating internal stakeholders, we’re ready to assist.

Forum takes the drama out of pharmacy—ensuring reliable medication access so residents and your business can thrive.