Health care coverage: antiretroviral drugs, drug devices, and drug products.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Vetoed
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill, the Protecting Rights, Expanding Prevention, and Advancing Reimbursement for Equity (PrEPARE) Act of 2025, aims to improve access to antiretroviral drugs, drug devices, and drug products used to prevent HIV/AIDS. It prohibits health care service plans and health insurers from requiring prior authorization or step therapy for these medications, unless a therapeutically equivalent option is already covered. The bill also mandates that plans cover non-self-administered versions of approved drugs and prohibits cost-sharing for preexposure prophylaxis, ensuring equitable access to these vital treatments.
Key provisions
- Prohibits prior authorization or step therapy for antiretroviral drugs, drug devices, and drug products used to prevent HIV/AIDS.
- Requires coverage of therapeutically equivalent versions of antiretroviral drugs without prior authorization if at least one equivalent version is already covered.
- Mandates coverage of non-self-administered antiretroviral drugs approved by the FDA for HIV prevention as an outpatient prescription drug benefit.
- Prohibits cost-sharing for HIV preexposure prophylaxis drugs.
- Exempts Medi-Cal managed care plans from these provisions.
- Specifies that long-acting drugs are not therapeutically equivalent to drugs with different durations.
- Requires nongrandfathered plans to provide coverage without cost-sharing for approved HIV preexposure prophylaxis drugs.
- Prohibits insurers from imposing cost-sharing on nonformulary drugs covered under an exception request if therapeutically equivalent options are covered without cost-sharing.
Bill text
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Sponsors
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6 on record
Primary sponsor
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