Bill > HR7189

This bill, known as the PrEP Access Act, aims to expand Medicare Part B coverage to include HIV prevention services provided by pharmacists. Specifically, it amends the Social Security Act to define "pharmacist-provided HIV prevention services" as those a pharmacist is legally authorized to provide under state law, including services and supplies related to the prevention of HIV. This encompasses services like evaluating, managing, screening, consulting, and counseling for pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), or other evidence-based HIV prevention interventions, as well as medication administration and related clinical diagnostic laboratory tests. The bill also outlines payment for these services, generally at 80% of the lesser of the actual charge or 85% of the amount determined by Medicare's physician payment system, and prohibits balance billing for these pharmacist services. These changes are set to take effect for services provided on or after January 1, 2027.

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https://www.congress.gov/bill/119th-congress/house-bill/7189/all-info