The legislation previously known as the Ensuring Community Access to Pharmacist Services Act (ECAPS) is now advancing as the Main Street Pharmacy Access Act. It is bipartisan legislation (S. 2426 and H.R. 3164) designed to recognize pharmacists as providers under Medicare Part B. Once passed, it will enable pharmacists to receive direct reimbursement for certain clinical services (such as influenza, COVID-19, streptococcal pharyngitis, RSV).

The Ensuring Community Access to Pharmacist Services Act (ECAPS) is bipartisan legislation (S. 2426 and H.R. 3164) designed to recognize pharmacists as providers under Medicare Part B. On May 21, 2026, in a markup session of the U.S. House Ways and Means Committee, it was renamed the Main Street Pharmacy Access Act.

For large chains, Main Street Pharmacy Access Act opens new revenue streams by reimbursing pharmacists for patient care services. Pharmacies that are ready to implement and scale these services will see increased patient access, stronger community ties, and improved margins.

When ECAPS passes, the pharmacies best positioned to bill and deliver services immediately will gain a first-mover advantage. Waiting until after passage to build infrastructure means lost revenue, delayed market entry, and possible patient leakage to competitors.

ECAPS is focused on Medicare beneficiaries.

ECAPS would cover test-to-treat services for flu, strep, Covid, and RSV for Medicare patients.

Workflow Services provides turnkey infrastructure for clinical services — including billing enablement, workflow design, technology integration, staff training, and scalable rollout support. We ensure your pharmacies are ready to capture reimbursement on Day 1.

No, ECAPS doesn’t replace or change dispensing. Instead, it adds new reimbursable care opportunities that can be layered into pharmacy operations without disrupting prescription fulfillment.

As soon as the bill passes and CMS issues implementation guidance, pharmacies prepared with billing and clinical workflows can begin submitting claims. Early movers are positioned to capture revenue fastest.

Initially, yes. The Main Street Pharmacy Access Act applies to Medicare Part B beneficiaries. But history shows that when Medicare establishes pharmacist reimbursement, commercial payers and Medicaid programs often follow suit.

See details on H.R. 3164 – 119th Congress here on congress.gov.

See details on its companion bill in the Senate: S.2426 – Equitable Community Access to Pharmacist Services Act 

Last updated on 7/7/26

** = original sponsor

* = original cosponsor

Sen. Thune, John [R-SD]**

Sen. Warner, Mark R. [D-VA]*

Sen. Tillis, Thomas [R-NC]*

Sen. Daines, Steve [R-MT]*

Sen. Hassan, Margaret Wood [D-NH]*

Sen. Warren, Elizabeth [D-MA]*

Sen. Welch, Peter [D-VT]*

Sen. Cortez Masto, Catherine [D-NV]*

Sen. Lankford, James [R-OK]

Sen. Blunt Rochester, Lisa [D-DE]

Sen. Cramer, Kevin [R-ND]

Sen. Klobuchar, Amy [D-MN]

Sen. Sullivan, Dan [R-AK]

Sen. Heinrich, Martin [D-NM]

Sen. Shaheen, Jeanne [D-NH]

Sen. Capito, Shelley Moore [R-WV]

Sen. Fischer, Deb [R-NE]

Sen. Murkowski, Lisa [R-AK]

Sen. Kaine, Tim [D-VA]

Sen. Coons, Christopher A. [D-DE]

Sen. Rounds, Mike [R-SD]

Sen. Schiff, Adam B. [D-CA]

Sen. Kennedy, John [R-LA]

Sen. Mullin, Markwayne [R-OK]

Sen. Marshall, Roger [R-KS]

Sen. Blackburn, Marsha [R-TN]

Sen. Peters, Gary C. [D-MI]

Sen. Whitehouse, Sheldon [D-RI]

Sen. Collins, Susan M. [R-ME]

Sen. Murray, Patty [D-WA]

Sen. McCormick, David [R-PA]

Sen. Merkley, Jeff [D-OR]

Rep. Smith, Adrian [R-NE-3]**

Rep. Schneider, Bradley Scott [D-IL-10]*

Rep. Harshbarger, Diana [R-TN-1]*

Rep. Matsui, Doris O. [D-CA-7]*

Rep. Kustoff, David [R-TN-8]

Rep. Sewell, Terri A. [D-AL-7]

Rep. Van Duyne, Beth [R-TX-24]

Rep. Doggett, Lloyd [D-TX-37]

Rep. Malliotakis, Nicole [R-NY-11]

Rep. Ciscomani, Juan [R-AZ-6]

Rep. Hern, Kevin [R-OK-1]

Rep. Moolenaar, John R. [R-MI-2]

Rep. Carey, Mike [R-OH-15]

Rep. Tenney, Claudia [R-NY-24]

Rep. Davids, Sharice [D-KS-3]

Rep. Craig, Angie [D-MN-2]

Rep. Trahan, Lori [D-MA-3]

Del. Norton, Eleanor Holmes [D-DC-At Large]

Rep. Yakym, Rudy [R-IN-2]

Rep. Bost, Mike [R-IL-12]

Rep. McCormick, Richard [R-GA-7]

Rep. LaHood, Darin [R-IL-16]

Rep. Krishnamoorthi, Raja [D-IL-8]

Rep. Tonko, Paul [D-NY-20]

Rep. Johnson, Dusty [R-SD-At Large]

Rep. DelBene, Suzan K. [D-WA-1]

Rep. Moore, Blake D. [R-UT-1]

Rep. Vindman, Eugene Simon [D-VA-7]

Rep. Fischbach, Michelle [R-MN-7]

Rep. McClellan, Jennifer L. [D-VA-4]

Rep. Kelly, Robin L. [D-IL-2]

Rep. McGuire, John J. [R-VA-5]

Rep. Carter, Earl L. "Buddy" [R-GA-1]

Rep. Moran, Nathaniel [R-TX-1]

Rep. Steube, W. Gregory [R-FL-17]

Rep. Auchincloss, Jake [D-MA-4]

Rep. Gottheimer, Josh [D-NJ-5]

Rep. Tran, Derek [D-CA-45]

Rep. Kiggans, Jennifer A. [R-VA-2]

Rep. Soto, Darren [D-FL-9]

Rep. Randall, Emily [D-WA-6]

Rep. Fitzpatrick, Brian K. [R-PA-1]

Rep. Hinson, Ashley [R-IA-2]

Rep. Owens, Burgess [R-UT-4]

Rep. Veasey, Marc A. [D-TX-33]

Rep. Gonzalez, Vicente [D-TX-34]

Rep. Miller, Carol D. [R-WV-1]

Rep. Mann, Tracey [R-KS-1]

Rep. Kim, Young [R-CA-40]

Rep. Flood, Mike [R-NE-1]

Rep. Salinas, Andrea [D-OR-6]

Rep. Peters, Scott H. [D-CA-50]

Rep. Wilson, Joe [R-SC-2]

Rep. Dingell, Debbie [D-MI-6]

Rep. Finstad, Brad [R-MN-1]

Rep. Bresnahan, Robert P. [R-PA-8]

Rep. Lee, Susie [D-NV-3]

Rep. Landsman, Greg [D-OH-1]

Rep. Begich, Nicholas J. [R-AK-At Large]

Rep. Allen, Rick W. [R-GA-12]

Rep. Rulli, Michael A. [R-OH-6]

Rep. Cohen, Steve [D-TN-9]

Rep. Tokuda, Jill N. [D-HI-2]

Rep. Bean, Aaron [R-FL-4]

Rep. Balderson, Troy [R-OH-12]

Rep. Perez, Marie Gluesenkamp [D-WA-3]

Rep. Houlahan, Chrissy [D-PA-6]

Rep. Bilirakis, Gus M. [R-FL-12]

Rep. Harder, Josh [D-CA-9]

Rep. Jackson, Jonathan L. [D-IL-1]

Rep. Nunn, Zachary [R-IA-3]

Rep. Weber, Randy K. Sr. [R-TX-14]

Rep. Feenstra, Randy [R-IA-4]

Rep. Dean, Madeleine [D-PA-4]

Rep. Quigley, Mike [D-IL-5]

Rep. Balint, Becca [D-VT-At Large]

Rep. Pingree, Chellie [D-ME-1]

Rep. Langworthy, Nicholas A. [R-NY-23]

Rep. Swalwell, Eric [D-CA-14]

Rep. Maloy, Celeste [R-UT-2]

Rep. Cline, Ben [R-VA-6]

Rep. Scott, Austin [R-GA-8]

Rep. Vasquez, Gabe [D-NM-2]

Rep. Neguse, Joe [D-CO-2]

Rep. Beatty, Joyce [D-OH-3]

Rep. Hill, J. French [R-AR-2]

Rep. Ross, Deborah K. [D-NC-2]

Rep. Clarke, Yvette D. [D-NY-9]

Rep. Aderholt, Robert B. [R-AL-4]

Rep. McDonald Rivet, Kristen [D-MI-8]

Rep. Pappas, Chris [D-NH-1]

Rep. Barragán, Nanette Diaz [D-CA-44]

Rep. Hudson, Richard [R-NC-9]

Rep. Bynum, Janelle S. [D-OR-5]

Rep. Crow, Jason [D-CO-6]

Rep. Rogers, Mike D. [R-AL-3]

Rep. Himes, James A. [D-CT-4]

Rep. Schweikert, David [R-AZ-1]

Rep. Kelly, Mike [R-PA-16]

Rep. Kean, Thomas H. [R-NJ-7]

Rep. Walberg, Tim [R-MI-5]

Rep. Fletcher, Lizzie [D-TX-7]

Rep. Thanedar, Shri [D-MI-13]

Rep. Williams, Nikema [D-GA-5]

Rep. Lee, Laurel M. [R-FL-15]

Rep. Rutherford, John H. [R-FL-5]

Rep. Bentz, Cliff [R-OR-2]

Rep. Biggs, Sheri [R-SC-3]

Rep. Pocan, Mark [D-WI-2]

Rep. Tlaib, Rashida [D-MI-12]

Rep. Fong, Vince [R-CA-20]

Rep. James, John [R-MI-10]

Rep. Houchin, Erin [R-IN-9]

Rep. Carter, Troy A. [D-LA-2]

Rep. Sykes, Emilia Strong [D-OH-13]

Rep. Womack, Steve [R-AR-3]

Rep. Rouzer, David [R-NC-7]

Rep. Westerman, Bruce [R-AR-4]

Rep. Pfluger, August [R-TX-11]

Rep. Fedorchak, Julie [R-ND-At Large]

Rep. Bishop, Sanford D. [D-GA-2]

Rep. Scanlon, Mary Gay [D-PA-5]

Del. Moylan, James C. [R-GU-At Large]

Rep. Menendez, Robert [D-NJ-8]

Rep. Fitzgerald, Scott [R-WI-5]

Rep. Barrett, Tom [R-MI-7]

Rep. Schakowsky, Janice D. [D-IL-9]

Rep. Wittman, Robert J. [R-VA-1]

Rep. Evans, Gabe [R-CO-8]

Rep. Salazar, Maria Elvira [R-FL-27]

Rep. Bacon, Don [R-NE-2]

Rep. Mackenzie, Ryan [R-PA-7]

Rep. Fry, Russell [R-SC-7]

Rep. Stauber, Pete [R-MN-8]

Rep. De La Cruz, Monica [R-TX-15]

Rep. Thompson, Glenn [R-PA-15]

Rep. Edwards, Chuck [R-NC-11]