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As the nation’s retail pharmacies move deeper into the business of providing healthcare services, they now want pharmacists to be paid by Medicare to immunize the nation’s seniors....Under legislation that is gaining rare bipartisan support and momentum in the House and Senate, particularly for a Congressional health bill, pharmacists would be paid to administer vaccines under Medicare part B...The pharmacies have formed a coalition known as “The Patient Access to Pharmacists’ Care Coalition,” to push for the legislation, known as the Pharmacy and Medically Underserved Areas of Enhancement Act (S. 314/H.R. 592). The coalition includes retailers and grocery store chains with pharmacies such as Walgreens Boots Alliance , CVS Health, Wal-Mart, Kroger, Rite-Aid and Target...It could bring in hundreds of millions of dollars to the drugstore industry given the growing business of providing vaccinations.

Wal-Mart Stores surprised everyone by highlighting reduced profits from its pharmacy business. In corporate-speak, these were called "headwinds from pharmacy reimbursements" on its quarterly and annual earnings. Investors took note, especially since Walmart usually discloses nothing about its pharmacy business. Walmart didn’t provide many details about what caused the margin reduction, but I believe two factors played a key role:

1. lower margins from newly insured consumers (compared with cash-pay consumers)
2. Walmart’s aggressive participation in preferred networks

Late last week, Walgreens Boots Alliance filed an 8-K with the full text of its merger agreement with Rite Aid….The document containing the Agreement and Plan of Merger weighs in at a hefty 137 pages. Below, I highlight four fun facts about the deal’s timing, its termination fees, and what the companies will do to achieve antitrust approval.

1. The deal must be completed before Halloween 2016.
2. If Rite Aid backs out of the deal, then it owes as much as $370 million to Walgreens Boots Alliance.
3. WBA could owe Rite Aid a termination fee as large as $650 million.
4. To get the deal approved, WBA is willing to dump as many as 1,000 stores.

Wal-Mart's second quarter earnings release this week highlighted one of the many effects of more people gaining health insurance under the Affordable Care Act: its pharmacies are no longer as profitable… is seeing lower reimbursement rates from drug insurance plans and a decline in high-margin cash transactions… one of the dirty secrets of the pharmacy industry that uninsured people frequently pay more for drugs than those with insurance…

Walgreens Boots Alliance Inc.’s deal to acquire Rite Aid Corp. is expected to draw antitrust scrutiny not only because the company would grow to 12,700 locations, but because of what goes on behind the scenes with drug payments…Federal Trade Commission…will look closely at whether the merging of the No. 1 and No. 3 pharmacy chains in the U.S. will lead to higher prices for prescription drugs...the FTC will probably review the approximately $9.4 billion deal market-by-market instead of on a national basis, since CVS, Walgreens, Wal-Mart and Rite Aid together control only about half of the U.S. retail pharmacy market...The rest is held by independent stores, smaller chains and mail-order companies. Walgreens is likely to sell or shutter some stores...