H.R. 6400

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6400 Introduced in House (IH)]

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119th CONGRESS
1st Session
H. R. 6400

To amend title 10, United States Code, to improve access to certain 
medications under the TRICARE program, and for other purposes.

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IN THE HOUSE OF REPRESENTATIVES

December 3, 2025

Mrs. Kiggans of Virginia (for herself, Ms. Goodlander, Mr. Luttrell, 
and Ms. Houlahan) introduced the following bill; which was referred to 
the Committee on Armed Services

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A BILL

To amend title 10, United States Code, to improve access to certain 
medications under the TRICARE program, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Rx Access, Choice, Cost Equity, and 
Supply Stability Act'' or the ``Rx ACCESS Act''.

SEC. 2. IMPROVEMENTS RELATING TO ACCESS, FAIRNESS, AND TRANSPARENCY 
UNDER TRICARE PHARMACY BENEFITS PROGRAM.

(a) Beneficiary Election of Prescription Refill Means.--Section 
1074g(a)(9) of title 10, United States Code, is amended--
(1) in subparagraph (A), by inserting ``, and ending on 
October 1, 2026'' after ``Beginning on October 1, 2015''; and
(2) by adding at the end the following new subparagraph:
``(D) Beginning on October 1, 2026, an eligible covered beneficiary 
may elect to receive non-generic prescription maintenance medications 
through any means described in paragraph (2)(E).''.
(b) Pharmacy Benefit Manager Reimbursement Standards; Independent 
Audits.--Section 1074g of title 10, United States Code, as amended by 
subsection (a), is further amended--
(1) by redesignating subsections (i) and (j) as subsections 
(j) and (k), respectively; and
(2) by inserting after subsection (h) the following new 
subsection:
``(i) Pharmacy Benefit Manager Reimbursement Standards.--(1) The 
Secretary of Defense shall ensure that, as a condition of any contract 
entered into for the administration of the TRICARE pharmacy benefits 
program, reimbursement to a TRICARE retail pharmacy described in 
subsection (a)(2)(E)(ii) for a pharmaceutical agent provided under such 
program shall be an amount that is at least equal to the sum of--
``(A) either--
``(i) the actual cost to the pharmacy of acquiring 
such pharmaceutical agent from a wholesaler, or
``(ii) in the case of a pharmaceutical agent 
included on the national average drug acquisition cost 
index published by the Administrator for the Centers 
for Medicare and Medicaid Services, a proxy amount 
calculated at a rate that is not lower than the 
national average acquisition cost for such 
pharmaceutical agent, as identified on such cost index 
as of the date of the adjudication of the claim for 
such reimbursement, and
``(B) a professional dispensing fee that is equal to the 
professional dispensing fee paid by the State in which the 
pharmacy is located under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) for dispensing a prescription drug.
``(2) The contractor administering the TRICARE pharmacy benefits 
program may not impose any fees on a TRICARE retail pharmacy, including 
point-of-sale fees, retroactive fees, or other indirect or hidden fees.
``(3)(A) Not less frequently than annually, the Comptroller General 
of the United States--
``(i) shall conduct an audit of--
``(I) data reported by the contractor responsible 
for the administration of the TRICARE pharmacy benefits 
program relating to the rates of reimbursement under 
paragraph (1) and any price concessions; and
``(II) the adequacy of the TRICARE retail pharmacy 
network and access by eligible covered beneficiaries to 
such network, including with respect to continuity of 
care, geographic accessibility (taking into account 
factors in addition to travel time to and from a 
pharmacy, with special consideration for rural and 
underserved areas), and the extent to which elections 
by such beneficiaries under subsection (a)(9) reflect 
personal preference; and
``(ii) submit the results of such audit to the Committees 
on Armed Services of the House of Representatives and the 
Senate.
``(B) The Secretary shall ensure that, as a condition of any 
contract entered into for the administration of the TRICARE pharmacy 
benefits program, the contractor provides the Comptroller General 
information required to conduct the audit under subparagraph (A).''.
(c) Report.--Not later than 90 days after the date of the enactment 
of this Act, the Secretary of Defense shall submit to the congressional 
defense committees (as defined in section 101(a)(16) of title 10, 
United States Code) a plan for the implementation of this section.
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