PrEP and PEP are Prevention Act

This bill aims to ensure comprehensive HIV prevention services are covered without cost to individuals across various health insurance programs. It specifically mandates no-cost coverage for prescription drugs approved by the Food and Drug Administration for HIV prevention, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) . This coverage also extends to administrative fees for these drugs, necessary laboratory and diagnostic procedures, HIV prevention counseling, and clinical follow-up and monitoring, all in line with current U.S. Public Health Service clinical guidelines. For private insurance , the bill amends the Public Health Service Act to require coverage of these services without cost-sharing. It also prohibits imposing preauthorization requirements for these HIV prevention services, with a limited exception if a therapeutically equivalent drug is covered without such requirements. These provisions are set to apply to plan years beginning after the bill's enactment. The legislation also significantly impacts public health programs. Medicare Part B will cover HIV prevention services, eliminating coinsurance and deductibles for beneficiaries. Similarly, Medicare Part D will no longer apply deductibles or cost-sharing for HIV prevention drugs. Furthermore, Medicaid and the Children's Health Insurance Program (CHIP) are amended to include these services as covered benefits, explicitly prohibiting any cost-sharing for them. Finally, health benefits plans under the Federal Employees Health Benefits Program must also provide these HIV prevention benefits without any cost-sharing requirements.