The TACT Act of 2023 requires health insurance plans and pharmacy benefits managers to speed up access to prescription oral medications. Under the bill, pharmacies must confirm within 24 hours whether they can dispense a prescription and must fill it within 72 hours if confirmed, or immediately notify the patient, doctor, and insurance plan if they cannot. If a contracted pharmacy cannot meet the deadline, patients can use any licensed pharmacy within a reasonable distance or capable of delivery, and their insurance plan must cover the medication at the same cost-sharing rates as in-network pharmacies would charge. The bill also requires insurance plans to make prior authorization decisions for oral medications within 72 hours, and establishes that pharmacy quality measures used for insurance reimbursement must relate only to factors the pharmacy can actually control. The Government Accountability Office must report to Congress within two years on how the changes affect medication access times, patient health outcomes, costs, and potential fraud or abuse, with the new requirements taking effect for insurance plans beginning January 1, 2024.
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