Bill > HB1301

This bill, known as the PrEP and PEP for Pennsylvania Act, requires health insurance policies in Pennsylvania to provide comprehensive coverage for HIV prevention medications and associated services without any out-of-pocket costs for patients. Specifically, the bill mandates that health insurance policies cover Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP), which are FDA-approved medications designed to prevent HIV transmission before and after potential exposure. The coverage includes all expenses related to these medications, such as laboratory tests, medication counseling visits, and prescription appointments. The bill prohibits insurance providers from moving these services to higher-cost specialty tiers and prevents them from requiring patients to see specialized physicians like infectious disease specialists or immunologists before accessing these medications, unless medically necessary. The legislation applies to all health insurance policies in the state, with implementation beginning 60 days after its effective date, and will be phased in based on when insurance policy forms or rates are filed or renewed. The goal of the bill is to increase access to crucial HIV prevention medications and make them financially accessible to all patients.

Health and Social Services

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=H&type=B&bn=1301