Bill > HR5127

This bill aims to ensure no-cost coverage of HIV prevention services across multiple health insurance programs, including private insurance, Medicare, Medicaid, Children's Health Insurance Program (CHIP), and federal employee health benefits. Specifically, the bill mandates that insurance plans cover pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) drugs without any cost-sharing, deductibles, or preauthorization requirements. The coverage includes not just the prescription drugs approved by the FDA for HIV prevention, but also related services such as administrative fees, laboratory tests, diagnostic procedures, HIV prevention counseling, risk assessment, medication adherence support, and clinical follow-up. For Medicare Part D and Medicaid/CHIP programs, this means completely eliminating copayments, coinsurance, and deductibles for these HIV prevention medications and services. The bill would apply to new plan years beginning after its enactment, with some flexibility for state legislatures to implement the changes. The comprehensive approach aims to reduce financial barriers to accessing critical HIV prevention services and ultimately help reduce HIV transmission rates.

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https://www.congress.gov/bill/119th-congress/house-bill/5127/all-info