Bill > AB554

This bill, known as the Protecting Rights, Expanding Prevention, and Advancing Reimbursement for Equity (PrEPARE) Act of 2025, aims to improve access to HIV prevention medications by modifying regulations for health care service plans and health insurers. The bill prohibits health care plans and insurers (except Medi-Cal managed care plans) from requiring prior authorization or step therapy for antiretroviral drugs, devices, and products necessary for HIV/AIDS prevention, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). It specifies that if multiple therapeutically equivalent versions of a drug exist, plans only need to cover at least one without prior authorization. The bill also requires nongrandfathered health plans and insurance policies to provide coverage for FDA-approved HIV preexposure prophylaxis drugs without any cost-sharing, and prohibits cost-sharing for nonformulary drugs that are therapeutically equivalent to formulary drugs. Additionally, the bill mandates that health plans covering non-self-administered HIV prevention drugs as a medical benefit must also include them as an outpatient prescription drug benefit. The legislation ensures that pharmacists can dispense these medications and that health plans reimburse their services, with some exceptions for specialized plans and out-of-network pharmacies.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB554