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PrEP Access and Coverage Act
12/30/2022, 3:04 AM
Summary of Bill HR 6117
PrEP is a medication that can significantly reduce the risk of HIV infection when taken consistently. However, the high cost of PrEP can be a barrier for many individuals who could benefit from it. The PrEP Access and Coverage Act aims to address this issue by mandating that insurance companies cover the cost of PrEP for individuals who are at high risk of HIV infection.
The bill also includes provisions to increase awareness and education about PrEP, as well as funding for programs to help individuals access and adhere to the medication. Additionally, the bill prohibits insurance companies from imposing cost-sharing requirements, such as copays or deductibles, for PrEP. Overall, the PrEP Access and Coverage Act is aimed at expanding access to this important HIV prevention tool and reducing barriers to care for individuals at risk of HIV infection. It is a bipartisan effort to improve public health outcomes and reduce the spread of HIV in the United States.
Congressional Summary of HR 6117
PrEP Access and Coverage Act
This bill requires private health insurance plans to cover prescription drugs that prevent HIV, including related screenings, diagnostic procedures, administrative fees, and clinical follow-ups, without any cost-sharing obligation for the plan holder. Further, insurance plans must not impose any preauthorization requirement for this coverage. These coverage requirements also apply to public health insurance programs, including Medicare, Medicaid, and the Children's Health Insurance Program.
Additionally, the bill prohibits denying, limiting, or qualifying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on an individual taking medication for HIV prevention.
The bill further requires the Department of Health and Human Services to award grants to states, or directly to eligible local organizations, to provide uninsured individuals and underinsured individuals access to prescription drugs and related services that prevent HIV. The Centers for Disease Control and Prevention also must develop a public awareness campaign that focuses efforts in communities with a high need for HIV prevention treatment.
