PrEP Access Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
This bill, the PrEP Access Act, aims to expand access to HIV prevention medication (PrEP) for Medicare beneficiaries. It allows pharmacists to provide PrEP services under Medicare Part B, similar to how physicians currently do. The bill also establishes payment rates for these pharmacist-provided services and clarifies that pharmacists are covered as providers for billing purposes. It includes a provision to prevent balance billing for these services.
Key provisions
- Allows pharmacists to furnish HIV prevention services under Medicare Part B.
- Defines ‘pharmacist-provided HIV prevention services’ to include evaluation, management, screening, consultation, and counseling related to PrEP and related interventions.
- Establishes payment rates for pharmacist-provided PrEP services at 80% of the physician rate.
- Includes pharmacists as covered practitioners for billing purposes.
- Prohibits balance billing for pharmacist-provided PrEP services.
- Specifies that the changes apply starting January 1, 2027.
Who is affected
- Medicare beneficiaries
- Pharmacists
- Physicians
- Pharmacy Benefit Managers
- The Medicare program
Notable changes
- Expands Medicare coverage to include pharmacist-provided PrEP services.
- Creates a specific definition of ‘pharmacist-provided HIV prevention services’.
Bill text
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Sponsors
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22 on record
Primary sponsor
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