Preserving Patient Access Act

The Preserving Patient Access Act requires health insurance plans to grant special enrollment periods when they remove a doctor from their network or stop covering a specific prescription drug that a patient has used recently. Under this bill, Medicare Advantage and individual market plans must allow individuals to join or switch plans within the same year if their current provider becomes out-of-network after a visit within the last two years or if a covered medication is dropped from the formulary within the last six months. These protections apply to both Medicare Advantage plans and private individual market plans, ensuring that patients can maintain access to their preferred doctors and medications without waiting for the annual open enrollment window. The changes are scheduled to take effect for plan years beginning on or after January 1, 2027.