S.4924

Preserving Patient Access Act ensures special enrollment periods for Medicare and individual market plans when formularies change or providers exit.

The Preserving Patient Access Act amends Medicare and individual market plans to establish special enrollment periods for beneficiaries. Under Medicare, beneficiaries can enroll in a new plan if their current plan implements a negative formulary change for a covered drug within the previous six months. Similarly, in the individual market, beneficiaries can enroll in a new plan if a provider they have visited within the last two years becomes out-of-network. These changes apply to plan years beginning on or after January 1, 2027.