Bill > SB936

This bill, known as the PEP for Pennsylvania Act, requires health insurance policies in Pennsylvania to provide coverage for postexposure prophylaxis (PEP) HIV medication, which is a medication approved by the FDA that can be taken after potential HIV exposure to prevent transmission. The bill defines "health insurance policy" broadly to include various types of individual and group health insurance plans, while specifically excluding certain limited benefit insurance types. Under the bill's mandated coverage provision, any health insurance policy delivered, issued, renewed, extended, or modified in Pennsylvania must cover PEP medication expenses. Additionally, the bill prohibits insurance providers from moving PEP medications into a specialty tier solely for financial gain and prevents health care plans from requiring counseling from an infectious disease specialist or immunologist to receive PEP medication unless it is medically necessary. The legislation will take effect 60 days after its enactment, aiming to improve access to critical preventive HIV treatment for Pennsylvania residents.

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https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=S&type=B&bn=936