Ways and Means Committee, Energy and Commerce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This legislative proposal aims to significantly expand access to HIV prevention services under Medicare Part B by including services furnished by pharmacists. It amends the Social Security Act to define "pharmacist-provided HIV prevention services" as those legally authorized by state law and related to the prevention of human immunodeficiency virus. These covered services encompass evaluation, management, screening, consultation, and counseling related to pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and other evidence-based interventions. This also includes medication administration and associated clinical diagnostic laboratory tests necessary for these prevention strategies. The bill establishes that Medicare will reimburse 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule amount for these services. Importantly, it prohibits pharmacists from balance billing beneficiaries for these covered HIV prevention services, ensuring predictable costs. These provisions are slated to take effect for services provided on or after January 1, 2027.
Get AI-generated questions to help you understand this bill better
Timeline
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Health
PrEP Access Act
USA119th CongressHR-7189| House
| Updated: 1/21/2026
This legislative proposal aims to significantly expand access to HIV prevention services under Medicare Part B by including services furnished by pharmacists. It amends the Social Security Act to define "pharmacist-provided HIV prevention services" as those legally authorized by state law and related to the prevention of human immunodeficiency virus. These covered services encompass evaluation, management, screening, consultation, and counseling related to pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and other evidence-based interventions. This also includes medication administration and associated clinical diagnostic laboratory tests necessary for these prevention strategies. The bill establishes that Medicare will reimburse 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule amount for these services. Importantly, it prohibits pharmacists from balance billing beneficiaries for these covered HIV prevention services, ensuring predictable costs. These provisions are slated to take effect for services provided on or after January 1, 2027.
Get AI-generated questions to help you understand this bill better
Timeline
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.