,,ii  #aafth ,,congress  #ast ,session  
,s4 #aibf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bj1     
#bjai,ms4 ,harris introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to increase access to          
pre-exposure prophylaxis to reduce the  
transmission of ,,hiv4  #a4 ,short title
 ,this ,act may be cited as the ,pr,e,p 
,access and ,coverage ,act4  #b4        
,findings ,congress finds as follows3   
7#a7 ,the ,centers for ,disease ,control
 and ,prevention estimates that         
approximately #a1ajj1jjj people in the  
,united ,states are living with ,,hiv4  
7#b7 ,in #bjag1 there were #ch1bha new  
diagnoses of ,,hiv in the ,united       
,states4  7#c7 ,,hiv disproportionately 
impacts gay and bisexual men1           
transgender women1 and1 in particular1  
people of color4 ,for example1 in #bjag 
approximately #ff percent of new ,,hiv  
diagnoses were among gay and bisexual   

men1 #dc percent of new ,,hiv diagnoses 
were among ,black people1 and #bf       
percent of new ,,hiv diagnoses were     
among ,latinx people4 ,recent studies   
suggest that transgender women are up to
 #di times more likely to be diagnosed  
with ,,hiv than the general population4 
,members of communities at the          
intersections of these groups are most  
heavily impacted4  7#d7 ,pre-exposure   
prophylaxis 7referred to in this section
 as ,pr,e,p7 is a daily antiretroviral  
medication that helps prevent           
individuals from acquiring ,,hiv4 ,daily
 ,pr,e,p use reduces the risk of getting
 ,,hiv from sex by over #ij percent4 ,it
 reduces the risk of getting ,,hiv from 
injection drug use by over #gj percent4 
7#e7 ,many individuals at risk of       
exposure to ,,hiv do not use ,pr,e,p4   
,of the approximately #a1ajj1jjj people 
in the ,united ,states who could benefit
 from ,pr,e,p1 only #g percent1 or      
#gh1cfj individuals1 filled             
prescriptions for the drug in #bjaf4    

7#f7 ,pr,e,p usage is inconsistent      
across racial and gender lines4 ,in     
#bjaf1 ,pr,e,p users were #fh4g percent 
,white1 #aa4b percent ,black1 and #ac4a 
percent ,latinx4 ,however1 individuals  
eligible for ,pr,e,p were #bf4c percent 
,white1 #dc4g percent ,black1 and #bd4g 
percent ,latinx4 ,additionally1 only    
#b4a percent of women eligible for      
,pr,e,p received a prescription in      
#bjaf4  7#g7 ,there is currently only   
one version of ,pr,e,p approved by the  
,food and ,drug ,administration1        
marketed under the brand name of        
,truvada1 which1 in #bjah1 had a list   
price of over #bj1jjj a year in the     
,united ,states4 ,a less expensive1     
generic version of ,pr,e,p is expected  
to be available in ,september #bjbj1 and
 other types of ,,hiv prevention        
treatments1 including oral pills1       
vaginal rings1 and long-acting          
injectables1 are currently in the       
research pipeline4  7#h7 ,section #bgac 
of the ,public ,health ,service ,act    

7#db ,u4,s4,c4 #cjj;gg-#ac7 requires    
most private health insurance plans to  
cover preventive services without       
cost-sharing1 including such services   
with a rating of ,a or ,b under         
recommendations of the ,united ,states  
,preventive ,services ,task ,force4 ,on 
,june #aa1 #bjai1 the ,united ,states   
,preventive ,services ,task ,force      
issued a final recommendation giving an 
,a grade for ,pr,e,p for individuals at 
high risk of ,,hiv2 non-grandfathered   
private health insurance plans will have
 to cover ,pr,e,p for such individuals  
without cost-sharing by #bjba4  7#i7    
,despite such recommendation of the     
,united ,states ,preventive ,services   
,task ,force1 access barriers to ,pr,e,p
 remain4 ,ancillary services necessary  
to maintain the ,pr,e,p regime1         
including subsequent provider visits1   
clinical testing1 and other services1   
can remain a cost-burden on patients4   
,additionally1 the new recommendations  
are not linked to coverage requirements 

for individuals with other types of     
insurance1 such as ,medicare or         
,medicaid4  7#aj7 ,expanding access to  
cost-free ,pr,e,p and ancillary services
 for all individuals1 including         
individuals who do not have health      
insurance1 is a critical step towards   
eliminating ,,hiv transmission4  #c4    
,coverage of ,,hiv testing and          
prevention services  7a7 ,private       
insurance  7#a7 ,in general ,section    
#bgac7;a7 of the ,public ,health        
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#ac7;a77 is amended-- 7,a7 in   
paragraph 7#b71 by striking 2 and and   
inserting a semicolon2  7,b7 in         
paragraph 7#c71 by striking the period  
and inserting a semicolon2  7,c7 in     
paragraph 7#d71 by striking the period  
and inserting a semicolon2  7,d7 in     
paragraph 7#e71 by striking the period  
and inserting 2 and2 and  7,e7 by adding
 at the end the following3  7#f7 any    
prescription drug approved by the ,food 
and ,drug ,administration for the       

prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  4  7#b7 ,prohibition on    
preauthorization requirements ,subpart  
,,ii of part ,a of title ,,xxvii of the 
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;gg-#aa et seq47 is       
amended by adding at the end the        
following3  #bgbi4 ,prohibition on      
preauthorization requirements with      
respect to certain services ,a group    
health plan or a health insurance issuer
 offering group or individual health    
insurance coverage shall not impose any 
pre-authorization requirements with     
respect to coverage of the services     
described in section #bgac7;a77#f74  4  
7b7 ,coverage under ,federal ,employees 
,health ,benefits ,program ,section     

#hijd of title #e1 ,united ,states      
,code1 is amended by adding at the end  
the following3  7c7 ,any health benefits
 plan offered under this chapter shall  
include benefits for1 and may not impose
 any cost sharing requirements for1 any 
prescription drug approved by the ,food 
and ,drug ,administration for the       
prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  4  7c7 ,medicaid  7#a7 ,in 
general ,section #aije of the ,social   
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is amended-- 7,a7 in subsection         
7a77#d7--  7i7 by striking and 7,d7 and 
inserting 7,d72 and  7ii7 by inserting 2
 and 7,e7 ,,hiv prevention services     
before the semicolon2 and  7,b7 by      
adding at the end the following new     

subsection3  7ff7 ,,hiv prevention      
services ,for purposes of subsection    
7a77#d77;,e71 the term ,,hiv prevention 
services means prescription drugs for   
the prevention of ,,hiv acquisition1    
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  4  7#b7 ,no cost sharing   
,title ,,xix of the ,social ,security   
,act 7#db ,u4,s4,c4 #acif et seq47 is   
amended-- 7,a7 in section #aiaf1 by     
inserting ,,hiv prevention services     
described in section #aije7;a77#d77;,e71
 after section #aije7;a77#d77;,c71 each 
place it appears2 and  7,b7 in section  
#aiaf;,a7b77#c77;,b71 by adding at the  
end the following new clause3  7xi7     
,,hiv prevention services described in  
section #aije7;a77#d77;,e74  4  7#c7    
,inclusion in benchmark coverage        

,section #aicg7;b77#g7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acifu-#g7;b77#g77 is amended-- 7,a7 in 
the paragraph header1 by inserting and  
,,hiv prevention services after         
supplies2 and  7,b7 by inserting 1 and1 
for any individual described in section 
#aije7;a77#d77;,e71 medical assistance  
for ,,hiv prevention services in        
accordance with such section before the 
period4  7d7 ,,chip  7#a7 ,in general   
,section #bajc7;c7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acig;cc7c771 as amended by section     
#ejbb of the ,,support for ,patients and
 ,communities ,act 7,public ,law        
#aae-bga71 is amended by adding at the  
end the following new paragraph3  7#aj7 
,,hiv prevention services ,the child    
health assistance provided to a targeted
 low-income child and the               
pregnancy-related assistance provided to
 a targeted low-income woman shall      
include coverage of ,,hiv prevention    
services 7as defined in section         

#aije7;ff774  4  7#b7 ,no cost sharing  
,section #bajc7;e77#b7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acig;cc7e77#b77 is amended by inserting
 1 for ,,hiv prevention services        
described in subsection 7c77#aj71 after 
subsection 7c77#a77;,d74  7#c7          
,conforming amendment ,section #bajc7;a7
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #acig;cc7a771 as amended by   
section #ejbb of the ,,support for      
,patients and ,communities ,act 7,public
 ,law #aae-bga71 is amended in the      
matter preceding paragraph 7#a7 by      
striking and 7#h7 and inserting 7#h71   
and 7#aj74  7#d7 ,effective date  7,a7  
,in general ,subject to subparagraph    
7,a71 the amendments made by subsection 
7c7 and this subsection shall take      
effect on ,january #a1 #bjba4  7,b7     
,delay permitted if ,state legislation  
required ,in the case of a ,state plan  
approved under title ,,xix of the       
,social ,security ,act which the        
,secretary of ,health and ,human        

,services determines requires ,state    
legislation 7other than legislation     
appropriating funds7 in order for the   
plan to meet the additional requirements
 imposed by this section1 the ,state    
plan shall not be regarded as failing to
 comply with the requirements of such   
title solely on the basis of the failure
 of the plan to meet such additional    
requirements before the #ast day of the 
#ast calendar quarter beginning after   
the close of the #ast regular session of
 the ,state legislature that ends after 
the #a-year period beginning with the   
date of the enactment of this section4  
,for purposes of the preceding sentence1
 in the case of a ,state that has a     
#b-year legislative session1 each year  
of the session is deemed to be a        
separate regular session of the ,state  
legislature4  7e7 ,waiver of            
cost-,sharing under ,medicare  7#a7     
,part ,b  7,a7 ,inclusion as a          
preventive service ,section             
#ahfa7;ddd77#c7 of the ,social ,security

 ,act 7#db ,u4,s4,c4 #aciex7ddd77#c77 is
 amended by adding at the end the       
following new subparagraph3  7,d7 ,drugs
 or biologicals approved by the ,food   
and ,drug ,administration for the       
prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  4  7,b7 ,elimination of    
coinsurance ,section #ahcc7;a77#a7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciel7a77#a77 is amended--   
7i7 by striking and 7,,cc7 and inserting
 7,,cc72 and  7ii7 by inserting before  
the semicolon at the end the following3 
1 and 7,,dd7 with respect to preventive 
services described in subparagraph 7,d7 
of section #ahfa7;ddd77#c71 the amount  
paid shall be #ajj percent of 7i7 except
 as provided in clause 7ii71 the lesser 

of the actual charge for the service or 
the amount determined under the fee     
schedule that applies to such treatment 
under this part1 and 7ii7 in the case of
 such services that are covered ,,opd   
services 7as defined in subsection      
7t77#a77;,b771 the amount determined    
under subsection 7t74  7,c7 ,exemption  
from part ,b deductible ,section        
#ahcc7;b7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #aciel7b77 is amended--  
7i7 in paragraph 7#i71 by striking and  
at the end2 and  7ii7 in paragraph      
7#aj71 by striking the period at the end
 and inserting 1 and 7#aa7 such         
deductible shall not apply with respect 
to preventive services described in     
subparagraph 7,d7 of section            
#ahfa7;ddd77#c744  7,d7 ,effective date 
,the amendments made by this paragraph  
shall apply to items and services       
furnished on or after ,january #a1      
#bjba4  7#b7 ,part ,d  7,a7 ,in general 
,section #ahfj;,d-#b7;b7 of the ,social 
,security ,act 7#db ,u4,s4,c4           

#aciew-#ajb7;b77 is amended-- 7i7 in    
paragraph 7#a77;,a71 by striking ,the   
coverage and inserting ,subject to      
paragraph 7#h71 the coverage2  7ii7 in  
paragraph 7#b77;,a71 by striking and    
7,d7 and inserting and 7,d7 and         
paragraph 7#h72  7iii7 in paragraph     
7#c77;,a71 by striking and 7#d7 and     
inserting 7#d71 and 7#h72  7iv7 in      
paragraph 7#d77;,a77i71 by striking ,the
 coverage and inserting ,subject to     
paragraph 7#h71 the coverage2 and  7v7  
by adding at the end the following new  
paragraph3  7#h7 ,limitations on        
cost-sharing for drugs for the          
prevention of ,,hiv acquisition  7,a7   
,in general ,for plan year #bjba and    
each subsequent plan year1 there shall  
be no cost-sharing under this part      
7including under section #ahad;,d-#ad7  
for covered part ,d drugs that are for  
the prevention of ,,hiv acquisition4    
7,b7 ,cost-sharing ,for purposes of     
subparagraph 7,a71 the elimination of   
cost-sharing shall include the          

following3 7i7 ,no application of       
deductible ,the waiver of the deductible
 under paragraph 7#a74  7ii7 ,no        
application of coinsurance ,the waiver  
of coinsurance under paragraph 7#b74    
7iii7 ,no application of initial        
coverage limit ,the initial coverage    
limit under paragraph 7#c7 shall not    
apply4  7iv7 ,no cost sharing above     
annual out-of-pocket threshold ,the     
waiver of cost sharing under paragraph  
7#d74  4  7,b7 ,conforming amendments to
 cost sharing for low-income individuals
 ,section #ahfj;,d-#ad7;a7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#aad7;a77 is amended--  7i7 in   
paragraph 7#a71 in the matter preceding 
subparagraph 7,a71 by striking ,in the  
case and inserting ,subject to section  
#ahfj;,d-#b7;b77#h71 in the case2 and   
7ii7 in paragraph 7#b71 in the matter   
preceding subparagraph 7,a71 by striking
 ,in the case and inserting ,subject to 
section #ahfj;,d-#b7;b77#h71 in the     
case4  7f7 ,coverage of ,,hiv prevention

 treatment by ,department of ,veterans  
,affairs  7#a7 ,elimination of          
medication copayments ,section          
#agbb;,a7a7 of title #ch1 ,united       
,states ,code1 is amended by adding at  
the end the following new paragraph3    
7#e7 ,paragraph 7#a7 does not apply to a
 medication for the prevention of ,,hiv 
acquisition4  4  7#b7 ,elimination of   
hospital care and medical services      
copayments ,section #agaj of such title 
is amended-- 7,a7 in subsection 7f7--   
7i7 by redesignating paragraph 7#e7 as  
paragraph 7#f72 and  7ii7 by inserting  
after paragraph 7#d7 the following new  
paragraph 7#e73  7#e7 ,a veteran shall  
not be liable to the ,united ,states    
under this subsection for any amounts   
for laboratory and other diagnostic     
procedures associated with the use of   
any prescription drug approved by the   
,food and ,drug ,administration for the 
prevention of ,,hiv acquisition1 or for 
laboratory or other diagnostic          
procedures associated with the use of   

such drugs1 or clinical follow up and   
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  2 and  7,b7 in subsection  
7g77#c71 by adding at the end the       
following new subparagraph3  7,c7 ,any  
prescription drug approved by the ,food 
and ,drug ,administration for the       
prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  4  7#c7 ,inclusion as      
preventive health service ,section      
#agja7i7 of such title is amended-- 7,a7
 in subparagraph 7,k71 by striking 2 and
 and inserting a semicolon2  7,b7 by    
redesignating subparagraph 7,l7 as      
subparagraph 7,m72 and  7,c7 by         

inserting after subparagraph 7,k7 the   
following new subparagraph 7,l73  7,l7  
any prescription drug approved by the   
,food and ,drug ,administration for the 
prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation2 and  4  7g7 ,coverage of    
,,hiv prevention treatment by           
,department of ,defense  7#a7 ,in       
general ,chapter #ee of title #aj1      
,united ,states ,code1 is amended by    
inserting after section #ajgi;c the     
following new section3  #ajgi;d4        
,coverage of ,,hiv prevention treatment 
7a7 ,in general ,the ,secretary of      
,defense shall ensure coverage under the
 ,,tricare program of ,,hiv prevention  
treatment described in subsection 7b7   
for any beneficiary under section       

#ajgd7;a7 of this title4  7b7 ,,hiv     
prevention treatment described ,,hiv    
prevention treatment described in this  
subsection includes any prescription    
drug approved by the ,food and ,drug    
,administration for the prevention of   
,,hiv acquisition1 laboratory and other 
diagnostic procedures associated with   
the use of such drugs1 and clinical     
follow up and monitoring1 including any 
related services recommended in current 
,united ,states ,public ,health ,service
 clinical practice guidelines1 without  
limitation4  7c7 ,no cost-,sharing      
,notwithstanding section #ajge1 #ajge;a1
 or #ajgd;g7a77#f7 of this title or any 
other provision of law1 there is no     
cost-sharing requirement for ,,hiv      
prevention treatment covered under this 
section4  4  7#b7 ,clerical amendment   
,the table of sections at the beginning 
of such chapter is amended by inserting 
after the item relating to section      
#ajgi;c the following new item3         
#ajgi;d4 ,coverage of ,,hiv prevention  

treatment4  4  7h7 ,indian ,health      
,service testing1 monitoring1 and       
prescription drugs for the prevention of
 ,,hiv acquisition ,the ,indian ,health 
,care ,improvement ,act is amended by   
inserting after section #bbc 7#be       
,u4,s4,c4 #afbav7 the following3  #bbd4 
,testing1 monitoring1 and prescription  
drugs for the prevention of ,,hiv       
acquisition  7a7 ,in general ,the       
,secretary1 acting through the ,service1
 ,indian tribes1 and tribal             
organizations1 shall provide funding for
 any prescription drug approved by the  
,food and ,drug ,administration for the 
prevention of ,,hiv acquisition1        
laboratory and other diagnostic         
procedures associated with the use of   
such drugs1 and clinical follow up and  
monitoring1 including any related       
services recommended in current ,united 
,states ,public ,health ,service        
clinical practice guidelines1 without   
limitation4  7b7 ,authorization of      
appropriations ,there are authorized to 

be appropriated to carry out this       
section such sums as may be necessary4  
4  7i7 ,effective date ,the amendments  
made by subsections 7a71 7b71 7e71 7f71 
7g71 and 7h7 shall take effect with     
respect to plan years beginning on or   
after ,january #a1 #bjba4  #d4          
,prohibition on denial of coverage or   
increase in premiums of life1           
disability1 or long-term care insurance 
for individuals taking medication for   
the prevention of ,,hiv acquisition  7a7
 ,prohibition ,notwithstanding any other
 provision of law1 it shall be unlawful 
to-- 7#a7 decline or limit coverage of a
 person under any life insurance policy1
 disability insurance policy1 or        
long-term care insurance policy1 on     
account of the individual taking        
medication for the purpose of preventing
 the acquisition of ,,hiv2  7#b7        
preclude an individual from taking      
medication for the purpose of preventing
 the acquisition of ,,hiv as a condition
 of receiving a life insurance policy1  

disability insurance policy1 or         
long-term care insurance policy2  7#c7  
consider whether an individual is taking
 medication for the purpose of          
preventing the acquisition of ,,hiv in  
determining the premium rate for        
coverage of such individual under a life
 insurance policy1 disability insurance 
policy1 or long-term care insurance     
policy2 or  7#d7 otherwise discriminate 
in the offering1 issuance1 cancellation1
 amount of such coverage1 price1 or any 
other condition of a life insurance     
policy1 disability insurance policy1 or 
long-term care insurance policy for an  
individual1 based solely and without any
 additional actuarial risks upon whether
 the individual is taking medication for
 the purpose of preventing the          
acquisition of ,,hiv4  7b7 ,enforcement 
,a ,state insurance regulator may take  
such actions to enforce subsection 7a7  
as are specifically authorized under the
 laws of such ,state4  7c7 ,definitions 
,in this section3 7#a7 ,disability      

insurance policy ,the term disability   
insurance policy means a contract under 
which an entity promises to pay a person
 a sum of money in the event that an    
illness or injury resulting in a        
disability prevents such person from    
working4  7#b7 ,life insurance policy   
,the term life insurance policy means a 
contract under which an entity promises 
to pay a designated beneficiary a sum of
 money upon the death of the insured4   
7#c7 ,long-term care insurance policy   
,the term long-term care insurance      
policy means a contract for which the   
only insurance protection provided under
 the contract is coverage of qualified  
long-term care services 7as defined in  
section #ggjb;,b7c7 of the ,internal    
,revenue ,code of #aihf74  #e4 ,public  
education campaign ,part ,p of title    
,,iii of the ,public ,health ,service   
,act 7#db ,u4,s4,c4 #bhj;g et seq47 is  
amended by adding at the end the        
following3  #cii,v-#g4 ,pre-exposure    
prophylaxis public education campaign   

7a7 ,in general ,the ,secretary1 acting 
through the ,director of the ,centers   
for ,disease ,control and ,prevention1  
shall establish a public health campaign
 for the purpose of educating the public
 on medication for the prevention of    
,,hiv acquisition4  7b7 ,requirements   
,in carrying out this section1 the      
,secretary shall ensure cultural        
competency and efficacy within high-need
 communities in which ,pr,e,p is        
underutilized by developing the campaign
 in collaboration with organizations    
that are indigenous to communities that 
are overrepresented in the domestic     
,,hiv epidemic1 including communities of
 color and the lesbian1 gay1 bisexual1  
transgender1 and queer community4 ,the  
,secretary shall ensure that the        
campaign is designed to increase        
awareness of the safety and             
effectiveness of ,pr,e,p1 the           
recommended clinical practices for      
providing ,pr,e,p-related clinical care1
 and the local availability of ,pr,e,p  

providers1 and to counter stigma        
associated with the use of ,pr,e,p4  7c7
 ,evaluation of program ,the ,secretary 
shall develop measures to evaluate the  
effectiveness of activities conducted   
under this section that are aimed at    
reducing disparities in access to       
,pr,e,p and supporting the local        
community4 ,such measures shall evaluate
 community outreach activities1 language
 services1 workforce cultural           
competence1 and other areas as          
determined by the ,secretary4  7d7      
,pr,e,p ,in this section1 the term      
,pr,e,p means any drug approved by the  
,food and ,drug ,administration for the 
purpose of pre-exposure prophylaxis with
 respect to ,,hiv4  7e7 ,authorization  
of appropriations ,there are authorized 
to be appropriated such sums as may be  
necessary for each of fiscal years #bjba
 through #bjbf4  4  #f4 ,patient        
confidentiality ,the ,secretary of      
,health and ,human ,services shall amend
 the regulations promulgated under      

section #bfd7;c7 of the ,health         
,insurance ,portability and             
,accountability ,act of #aiif 7#db      
,u4,s4,c4 #acbj;d-#b note71 as          
necessary1 to ensure that individuals   
are able to access the benefits         
described in section #bgac7;a77#f7 under
 a family plan without any other        
individual enrolled in such family plan1
 including a primary subscriber of or   
policyholder1 being informed of such use
 of such benefits4  #g4 ,pre-exposure   
prophylaxis funding  7a7 ,in general    
,not later than #a year after the date  
of enactment of this ,act1 the          
,secretary of ,health and ,human        
,services 7in this ,act referred to as  
the ,secretary7 shall establish a       
program that provides grants to ,states1
 territories1 and ,indian ,tribes for   
the establishment and support of        
pre-exposure prophylaxis 7referred to in
 this section as ,pr,e,p7 programs1 or  
establishes a program for providing     
,federal funding directly to eligible   

entities within a ,state1 territory1 or 
,indian ,tribal territory1 in the case  
of a ,state1 territory1 or ,indian      
,tribe that does not apply for such a   
grant4  7b7 ,grant program  7#a7        
,applications ,to be eligible to receive
 a grant under subsection 7a71 a ,state1
 territory1 or ,indian ,tribe shall--   
7,a7 submit an application to the       
,secretary at such time1 in such manner1
 and containing such information as the 
,secretary may require1 including a     
description of how any funds awarded    
will be used and a plan describing how  
any funds awarded will be used to       
increase access to ,pr,e,p for uninsured
 individuals and reduce disparities in  
access to ,pr,e,p2 and  7,b7 appoint a  
,pr,e,p grant administrator to manage   
the program4  7#b7 ,use of funds ,any   
,state1 ,territory of the ,united       
,states1 or ,indian ,tribe that is      
awarded funds under subsection 7a7 shall
 use such funds for eligible ,pr,e,p    
expenses4  7c7 ,federal program  7#a7   

,in general ,in the case of a ,state1   
territory1 or ,indian ,tribe that does  
not submit an application under         
subsection 7b71 the ,secretary shall    
provide funding to any of the following1
 within the applicable ,state1          
territory1 or ,indian ,tribal territory3
  7,a7 ,federally qualified health      
centers 7as defined in section          
#ahfa7;aa77#d7 of the ,social ,security 
,act 7#db ,u4,s4,c4 #aciex7aa77#d774    
7,b7 ,family planning grantees 7other   
than ,states7 funded under section #ajja
 of the ,public ,health ,service ,act   
7#db ,u4,s4,c4 #cjj74  7,c7 ,rural      
health clinics 7as defined in section   
#ahfa7;aa77#b7 of the ,social ,security 
,act 7#db ,u4,s4,c4 #aciex7aa77#b774    
7,d7 ,health facilities operated by or  
pursuant to a contract with the ,indian 
,health ,service4  7,e7 ,community-based
 organizations1 clinics1 hospitals1 and 
other health facilities that provide    
services to individuals at risk for or  
living with ,,hiv4  7,f7 ,nonprofit     

private entities providing comprehensive
 primary care to populations at risk of 
,,hiv1 including faith-based and        
community-based organizations4  7#b7    
,use of funds ,any entity receiving     
funding under paragraph 7#a7 shall use  
such funds for eligible ,pr,e,p         
expenses4  7d7 ,eligible ,pr,e,p        
expenses  7#a7 ,in general ,the         
,secretary shall publish a list of      
expenses that qualify as eligible       
,pr,e,p expenses for purposes of this   
section4  7#b7 ,inclusions ,such list   
shall include-- 7,a7 any prescription   
drug approved by the ,food and ,drug    
,administration for the prevention of   
,,hiv acquisition1 laboratory and other 
diagnostic procedures associated with   
the use of such drugs1 and clinical     
follow up and monitoring1 including any 
related services recommended in current 
,united ,states ,public ,health ,service
 clinical practice guidelines1 without  
limitation2  7,b7 outreach and public   
education activities directed toward    

populations overrepresented in the      
domestic ,,hiv epidemic that increase   
awareness about the existence of        
,pr,e,p1 provide education about access 
to and health care coverage of ,pr,e,p1 
and counter stigma associated with the  
use of ,pr,e,p2 and  7,c7 outreach      
activities directed toward physicians   
and other providers that provide        
education about ,pr,e,p4  7e7 ,report to
 ,congress ,the ,secretary shall1 in    
each of the first #e years beginning one
 year after the date of the enactment of
 this ,act1 submit to ,congress1 and    
make public on the internet website of  
,department of ,health and ,human       
,services1 a report on the impact of any
 grants provided to ,states1            
territories1 and ,indian ,tribes for the
 establishment and support of           
pre-exposure prophylaxis programs under 
this section4  7f7 ,authorization of    
,appropriations ,there are authorized to
 be appropriated to carry out this      
section #fj1jjj1jjj for each of the     

first #e fiscal years beginning after   
the date of the enactment of this       
section4  #h4 ,clarification ,this ,act1
 including the amendments made by this  
,act1 shall apply notwithstanding any   
other provision of law1 including       
,public ,law #ajc-ada4  #i4 ,private    
right of action ,any person aggrieved by
 a violation of this ,act1 including the
 amendments made by this ,act1 may      
commence a civil action in an           
appropriate ,united ,states ,district   
,court or other court of competent      
jurisdiction to obtain relief as allowed
 by law as either an individual or      
member of a class4 ,if the plaintiff is 
the prevailing party in such an action1 
the court shall order the defendant to  
pay the costs and reasonable attorney   
fees of the plaintiff4