,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #aibf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #bj1 #bjai,ms4   
,h>ris introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to increase access to       
pre-exposure prophylaxis to r$uce !     
transmission ( ,,hiv4  #a4 ,%ort title  
,?is ,act may be cit$ z ! ,pr,e,p       
,access & ,cov]age ,act4  #b4 ,f9d+s    
,congress f9ds z foll[s3 7#a7 ,! ,c5t]s 
= ,disease ,control & ,prev5tion        
e/imates t approximately #a1ajj1jjj p 9 
! ,unit$ ,/ates are liv+ ) ,,hiv4  7#b7 
,9 #bjag1 !re 7 #ch1bha new diagnoses ( 
,,hiv 9 ! ,unit$ ,/ates4  7#c7 ,,hiv    
disproportionately impacts gay &        
bisexual m51 transg5d] wom51 &1 9       
p>ticul>1 p ( color4 ,= example1 9 #bjag
 approximately #ff p]c5t ( new ,,hiv    
diagnoses 7 among gay & bisexual m51 #dc
 p]c5t ( new ,,hiv diagnoses 7 among    
,black p1 & #bf p]c5t ( new ,,hiv       
diagnoses 7 among ,lat9x p4 ,rec5t      

/udies sugge/ t transg5d] wom5 are up to
 #di times m likely to be diagnos$ )    
,,hiv ?an ! g5]al population4 ,memb]s ( 
communities at ! int]sections ( ^! gr\ps
 are mo/ heavily impact$4  7#d7         
,pre-exposure prophylaxis 7ref]r$ to 9  
?is section z ,pr,e,p7 is a daily       
antiretroviral m$ication t helps prev5t 
individuals f acquir+ ,,hiv4 ,daily     
,pr,e,p use r$uces ! risk ( gett+ ,,hiv 
f sex by ov] #ij p]c5t4 ,x r$uces ! risk
 ( gett+ ,,hiv f injection drug use by  
ov] #gj p]c5t4  7#e7 ,_m individuals at 
risk ( exposure to ,,hiv d n use        
,pr,e,p4 ,( ! approximately #a1ajj1jjj p
 9 ! ,unit$ ,/ates :o c\ld b5efit f     
,pr,e,p1 only #g p]c5t1 or #gh1cfj      
individuals1 fill$ prescriptions = !    
drug 9 #bjaf4  7#f7 ,pr,e,p usage is    
inconsi/5t across racial & g5d] l9es4 ,9
 #bjaf1 ,pr,e,p us]s 7 #fh4g p]c5t      
,:ite1 #aa4b p]c5t ,black1 & #ac4a p]c5t
 ,lat9x4 ,h[ev]1 individuals eligible = 
,pr,e,p 7 #bf4c p]c5t ,:ite1 #dc4g p]c5t
 ,black1 & #bd4g p]c5t ,lat9x4          

,additionally1 only #b4a p]c5t ( wom5   
eligible = ,pr,e,p receiv$ a            
prescription 9 #bjaf4  7#g7 ,!re is     
curr5tly only "o v]sion ( ,pr,e,p       
approv$ by ! ,food & ,drug              
,adm9i/ration1 m>ket$ "u ! br& "n (     
,truvada1 :i*1 9 #bjah1 _h a li/ price (
 ov] #bj1jjj a ye> 9 ! ,unit$ ,/ates4 ,a
 less exp5sive1 g5]ic v]sion ( ,pr,e,p  
is expect$ to be available 9 ,septemb]  
#bjbj1 & o!r types ( ,,hiv prev5tion    
treatm5ts1 includ+ oral pills1 vag9al   
r+s1 & long-act+ injectables1 are       
curr5tly 9 ! rese>* pipel9e4  7#h7      
,section #bgac ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ac7
 requires mo/ private heal? insurance   
plans to cov] prev5tive s]vices )\t     
co/-%>+1 includ+ su* s]vices ) a rat+ ( 
,a or ,b "u recomm5dations ( ! ,unit$   
,/ates ,prev5tive ,s]vices ,task ,=ce4  
,on ,june #aa1 #bjai1 ! ,unit$ ,/ates   
,prev5tive ,s]vices ,task ,=ce issu$ a  
f9al recomm5dation giv+ an ,a grade =   
,pr,e,p = individuals at high risk (    

,,hiv2 non-gr&fa!r$ private heal?       
insurance plans w h to cov] ,pr,e,p =   
su* individuals )\t co/-%>+ by #bjba4   
7#i7 ,despite su* recomm5dation ( !     
,unit$ ,/ates ,prev5tive ,s]vices ,task 
,=ce1 access b>ri]s to ,pr,e,p rema94   
,ancill>y s]vices necess>y to ma9ta9 !  
,pr,e,p regime1 includ+ subsequ5t       
provid] visits1 cl9ical te/+1 & o!r     
s]vices1 c rema9 a co/-burd5 on pati5ts4
 ,additionally1 ! new recomm5dations are
 n l9k$ to cov]age requirem5ts =        
individuals ) o!r types ( insurance1 su*
 z ,m$ic>e or ,m$icaid4  7#aj7 ,exp&+   
access to co/-free ,pr,e,p & ancill>y   
s]vices = all individuals1 includ+      
individuals :o d n h heal? insurance1 is
 a critical /ep t[>ds elim9at+ ,,hiv    
transmission4  #c4 ,cov]age ( ,,hiv te/+
 & prev5tion s]vices  7a7 ,private      
insurance  7#a7 ,9 g5]al ,section       
#bgac7;a7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #cjj;gg-#ac7;a77 is 
am5d$-- 7,a7 9 p>agraph 7#b71 by /rik+ 2
 & & ins]t+ a semicolon2  7,b7 9        

p>agraph 7#c71 by /rik+ ! p]iod & ins]t+
 a semicolon2  7,c7 9 p>agraph 7#d71 by 
/rik+ ! p]iod & ins]t+ a semicolon2     
7,d7 9 p>agraph 7#e71 by /rik+ ! p]iod &
 ins]t+ 2 &2 &  7,e7 by add+ at ! end ! 
foll[+3  7#f7 any prescription drug     
approv$ by ! ,food & ,drug ,adm9i/ration
 = ! prev5tion ( ,,hiv acquisition1     
laboratory & o!r diagno/ic proc$ures    
associat$ ) ! use ( su* drugs1 & cl9ical
 foll[ up & monitor+1 includ+ any relat$
 s]vices recomm5d$ 9 curr5t ,unit$      
,/ates ,public ,heal? ,s]vice cl9ical   
practice guidel9es1 )\t limitation4  4  
7#b7 ,prohibition on preau?orization    
requirem5ts ,subp>t ,,ii ( "p ,a ( title
 ,,xxvii ( ! ,public ,heal? ,s]vice ,act
 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47 is 
am5d$ by add+ at ! end ! foll[+3  #bgbi4
 ,prohibition on preau?orization        
requirem5ts ) respect to c]ta9 s]vices  
,a gr\p heal? plan or a heal? insurance 
issu] (f]+ gr\p or individual heal?     
insurance cov]age %all n impose any     
pre-au?orization requirem5ts ) respect  

to cov]age ( ! s]vices describ$ 9       
section #bgac7;a77#f74  4  7b7 ,cov]age 
"u ,f$]al ,employees ,heal? ,b5efits    
,program ,section #hijd ( title #e1     
,unit$ ,/ates ,code1 is am5d$ by add+ at
 ! end ! foll[+3  7c7 ,any heal? b5efits
 plan (f]$ "u ?is *apt] %all include    
b5efits =1 & may n impose any co/ %>+   
requirem5ts =1 any prescription drug    
approv$ by ! ,food & ,drug ,adm9i/ration
 = ! prev5tion ( ,,hiv acquisition1     
laboratory & o!r diagno/ic proc$ures    
associat$ ) ! use ( su* drugs1 & cl9ical
 foll[ up & monitor+1 includ+ any relat$
 s]vices recomm5d$ 9 curr5t ,unit$      
,/ates ,public ,heal? ,s]vice cl9ical   
practice guidel9es1 )\t limitation4  4  
7c7 ,m$icaid  7#a7 ,9 g5]al ,section    
#aije ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif;d7 is am5d$-- 7,a7 9    
subsection 7a77#d7--  7i7 by /rik+ &    
7,d7 & ins]t+ 7,d72 &  7ii7 by ins]t+ 2 
& 7,e7 ,,hiv prev5tion s]vices be=e !   
semicolon2 &  7,b7 by add+ at ! end !   
foll[+ new subsection3  7ff7 ,,hiv      

prev5tion s]vices ,= purposes (         
subsection 7a77#d77;,e71 ! t]m ,,hiv    
prev5tion s]vices means prescription    
drugs = ! prev5tion ( ,,hiv acquisition1
 laboratory & o!r diagno/ic proc$ures   
associat$ ) ! use ( su* drugs1 & cl9ical
 foll[ up & monitor+1 includ+ any relat$
 s]vices recomm5d$ 9 curr5t ,unit$      
,/ates ,public ,heal? ,s]vice cl9ical   
practice guidel9es1 )\t limitation4  4  
7#b7 ,no co/ %>+ ,title ,,xix ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 is am5d$-- 7,a7 9 section
 #aiaf1 by ins]t+ ,,hiv prev5tion       
s]vices describ$ 9 section              
#aije7;a77#d77;,e71 aft] section        
#aije7;a77#d77;,c71 ea* place x appe>s2 
&  7,b7 9 section #aiaf;,a7b77#c77;,b71 
by add+ at ! end ! foll[+ new clause3   
7xi7 ,,hiv prev5tion s]vices describ$ 9 
section #aije7;a77#d77;,e74  4  7#c7    
,inclusion 9 b5*m>k cov]age ,section    
#aicg7;b77#g7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifu-#g7;b77#g77 is   
am5d$-- 7,a7 9 ! p>agraph head]1 by     

ins]t+ & ,,hiv prev5tion s]vices aft]   
supplies2 &  7,b7 by ins]t+ 1 &1 = any  
individual describ$ 9 section           
#aije7;a77#d77;,e71 m$ical assi/ance =  
,,hiv prev5tion s]vices 9 accordance )  
su* section be=e ! p]iod4  7d7 ,,*ip    
7#a7 ,9 g5]al ,section #bajc7;c7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc7c771 z am5d$ by section #ejbb (
 ! ,,support = ,pati5ts & ,communities  
,act 7,public ,law #aae-bga71 is am5d$  
by add+ at ! end ! foll[+ new p>agraph3 
7#aj7 ,,hiv prev5tion s]vices ,! *ild   
heal? assi/ance provid$ to a t>get$     
l[-income *ild & ! pregnancy-relat$     
assi/ance provid$ to a t>get$ l[-income 
woman %all include cov]age ( ,,hiv      
prev5tion s]vices 7z def9$ 9 section    
#aije7;ff774  4  7#b7 ,no co/ %>+       
,section #bajc7;e77#b7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acig;cc7e77#b77 is am5d$ by ins]t+ 1 = 
,,hiv prev5tion s]vices describ$ 9      
subsection 7c77#aj71 aft] subsection    
7c77#a77;,d74  7#c7 ,con=m+ am5dm5t     

,section #bajc7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acig;cc7a771 z    
am5d$ by section #ejbb ( ! ,,support =  
,pati5ts & ,communities ,act 7,public   
,law #aae-bga71 is am5d$ 9 ! matt]      
prec$+ p>agraph 7#a7 by /rik+ & 7#h7 &  
ins]t+ 7#h71 & 7#aj74  7#d7 ,effective  
date  7,a7 ,9 g5]al ,subject to         
subp>agraph 7,a71 ! am5dm5ts made by    
subsection 7c7 & ?is subsection %all    
take effect on ,janu>y #a1 #bjba4  7,b7 
,delay p]mitt$ if ,/ate legislation     
requir$ ,9 ! case ( a ,/ate plan approv$
 "u title ,,xix ( ! ,social ,security   
,act :i* ! ,secret>y ( ,heal? & ,human  
,s]vices det]m9es requires ,/ate        
legislation 7o!r ?an legislation        
appropriat+ funds7 9 ord] = ! plan to   
meet ! additional requirem5ts impos$ by 
?is section1 ! ,/ate plan %all n be     
reg>d$ z fail+ to comply ) ! requirem5ts
 ( su* title solely on ! basis ( !      
failure ( ! plan to meet su* additional 
requirem5ts be=e ! #a/ day ( ! #a/      
cal5d> qu>t] beg9n+ aft] ! close ( ! #a/

 regul> session ( ! ,/ate legislature t 
ends aft] ! #a-ye> p]iod beg9n+ ) ! date
 ( ! enactm5t ( ?is section4 ,= purposes
 ( ! prec$+ s5t5ce1 9 ! case ( a ,/ate t
 has a #b-ye> legislative session1 ea*  
ye> ( ! session is deem$ to be a sep>ate
 regul> session ( ! ,/ate legislature4  
7e7 ,waiv] ( co/-,%>+ "u ,m$ic>e  7#a7  
,"p ,b  7,a7 ,inclusion z a prev5tive   
s]vice ,section #ahfa7;ddd77#c7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ddd77#c77 is am5d$ by add+ at !  
end ! foll[+ new subp>agraph3  7,d7     
,drugs or biologicals approv$ by ! ,food
 & ,drug ,adm9i/ration = ! prev5tion (  
,,hiv acquisition1 laboratory & o!r     
diagno/ic proc$ures associat$ ) ! use ( 
su* drugs1 & cl9ical foll[ up &         
monitor+1 includ+ any relat$ s]vices    
recomm5d$ 9 curr5t ,unit$ ,/ates ,public
 ,heal? ,s]vice cl9ical practice        
guidel9es1 )\t limitation4  4  7,b7     
,elim9ation ( co9surance ,section       
#ahcc7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciel7a77#a77 is       

am5d$-- 7i7 by /rik+ & 7,,cc7 & ins]t+  
7,,cc72 &  7ii7 by ins]t+ be=e !        
semicolon at ! end ! foll[+3 1 & 7,,dd7 
) respect to prev5tive s]vices describ$ 
9 subp>agraph 7,d7 ( section            
#ahfa7;ddd77#c71 ! am\nt paid %all be   
#ajj p]c5t ( 7i7 except z provid$ 9     
clause 7ii71 ! less] ( ! actual *>ge = !
 s]vice or ! am\nt det]m9$ "u ! fee     
s*$ule t applies to su* treatm5t "u ?is 
"p1 & 7ii7 9 ! case ( su* s]vices t are 
cov]$ ,,opd s]vices 7z def9$ 9          
subsection 7t77#a77;,b771 ! am\nt       
det]m9$ "u subsection 7t74  7,c7        
,exemption f "p ,b d$uctible ,section   
#ahcc7;b7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciel7b77 is am5d$-- 7i7
 9 p>agraph 7#i71 by /rik+ & at ! end2 &
  7ii7 9 p>agraph 7#aj71 by /rik+ !     
p]iod at ! end & ins]t+ 1 & 7#aa7 su*   
d$uctible %all n apply ) respect to     
prev5tive s]vices describ$ 9 subp>agraph
 7,d7 ( section #ahfa7;ddd77#c744  7,d7 
,effective date ,! am5dm5ts made by ?is 
p>agraph %all apply to items & s]vices  

furni%$ on or aft] ,janu>y #a1 #bjba4   
7#b7 ,"p ,d  7,a7 ,9 g5]al ,section     
#ahfj;,d-#b7;b7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciew-#ajb7;b77 is 
am5d$-- 7i7 9 p>agraph 7#a77;,a71 by    
/rik+ ,! cov]age & ins]t+ ,subject to   
p>agraph 7#h71 ! cov]age2  7ii7 9       
p>agraph 7#b77;,a71 by /rik+ & 7,d7 &   
ins]t+ & 7,d7 & p>agraph 7#h72  7iii7 9 
p>agraph 7#c77;,a71 by /rik+ & 7#d7 &   
ins]t+ 7#d71 & 7#h72  7iv7 9 p>agraph   
7#d77;,a77i71 by /rik+ ,! cov]age &     
ins]t+ ,subject to p>agraph 7#h71 !     
cov]age2 &  7v7 by add+ at ! end !      
foll[+ new p>agraph3  7#h7 ,limitations 
on co/-%>+ = drugs = ! prev5tion ( ,,hiv
 acquisition  7,a7 ,9 g5]al ,= plan ye> 
#bjba & ea* subsequ5t plan ye>1 !re %all
 be no co/-%>+ "u ?is "p 7includ+ "u    
section #ahad;,d-#ad7 = cov]$ "p ,d     
drugs t are = ! prev5tion ( ,,hiv       
acquisition4  7,b7 ,co/-%>+ ,= purposes 
( subp>agraph 7,a71 ! elim9ation (      
co/-%>+ %all include ! foll[+3 7i7 ,no  
application ( d$uctible ,! waiv] ( !    

d$uctible "u p>agraph 7#a74  7ii7 ,no   
application ( co9surance ,! waiv] (     
co9surance "u p>agraph 7#b74  7iii7 ,no 
application ( initial cov]age limit ,!  
initial cov]age limit "u p>agraph 7#c7  
%all n apply4  7iv7 ,no co/ %>+ above   
annual out-(-pocket ?re%old ,! waiv] (  
co/ %>+ "u p>agraph 7#d74  4  7,b7      
,con=m+ am5dm5ts to co/ %>+ = l[-income 
individuals ,section #ahfj;,d-#ad7;a7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciew-#aad7;a77 is am5d$--  7i7 9      
p>agraph 7#a71 9 ! matt] prec$+         
subp>agraph 7,a71 by /rik+ ,9 ! case &  
ins]t+ ,subject to section              
#ahfj;,d-#b7;b77#h71 9 ! case2 &  7ii7 9
 p>agraph 7#b71 9 ! matt] prec$+        
subp>agraph 7,a71 by /rik+ ,9 ! case &  
ins]t+ ,subject to section              
#ahfj;,d-#b7;b77#h71 9 ! case4  7f7     
,cov]age ( ,,hiv prev5tion treatm5t by  
,dep>tm5t ( ,vet]ans ,affairs  7#a7     
,elim9ation ( m$ication copaym5ts       
,section #agbb;,a7a7 ( title #ch1 ,unit$
 ,/ates ,code1 is am5d$ by add+ at ! end

 ! foll[+ new p>agraph3  7#e7 ,p>agraph 
7#a7 does n apply to a m$ication = !    
prev5tion ( ,,hiv acquisition4  4  7#b7 
,elim9ation ( hospital c>e & m$ical     
s]vices copaym5ts ,section #agaj ( su*  
title is am5d$-- 7,a7 9 subsection 7f7--
  7i7 by r$esignat+ p>agraph 7#e7 z     
p>agraph 7#f72 &  7ii7 by ins]t+ aft]   
p>agraph 7#d7 ! foll[+ new p>agraph     
7#e73  7#e7 ,a vet]an %all n be liable  
to ! ,unit$ ,/ates "u ?is subsection =  
any am\nts = laboratory & o!r diagno/ic 
proc$ures associat$ ) ! use ( any       
prescription drug approv$ by ! ,food &  
,drug ,adm9i/ration = ! prev5tion (     
,,hiv acquisition1 or = laboratory or   
o!r diagno/ic proc$ures associat$ ) !   
use ( su* drugs1 or cl9ical foll[ up &  
monitor+1 includ+ any relat$ s]vices    
recomm5d$ 9 curr5t ,unit$ ,/ates ,public
 ,heal? ,s]vice cl9ical practice        
guidel9es1 )\t limitation4  2 &  7,b7 9 
subsection 7g77#c71 by add+ at ! end !  
foll[+ new subp>agraph3  7,c7 ,any      
prescription drug approv$ by ! ,food &  

,drug ,adm9i/ration = ! prev5tion (     
,,hiv acquisition1 laboratory & o!r     
diagno/ic proc$ures associat$ ) ! use ( 
su* drugs1 & cl9ical foll[ up &         
monitor+1 includ+ any relat$ s]vices    
recomm5d$ 9 curr5t ,unit$ ,/ates ,public
 ,heal? ,s]vice cl9ical practice        
guidel9es1 )\t limitation4  4  7#c7     
,inclusion z prev5tive heal? s]vice     
,section #agja7i7 ( su* title is am5d$--
 7,a7 9 subp>agraph 7,k71 by /rik+ 2 & &
 ins]t+ a semicolon2  7,b7 by r$esignat+
 subp>agraph 7,l7 z subp>agraph 7,m72 & 
7,c7 by ins]t+ aft] subp>agraph 7,k7 !  
foll[+ new subp>agraph 7,l73  7,l7 any  
prescription drug approv$ by ! ,food &  
,drug ,adm9i/ration = ! prev5tion (     
,,hiv acquisition1 laboratory & o!r     
diagno/ic proc$ures associat$ ) ! use ( 
su* drugs1 & cl9ical foll[ up &         
monitor+1 includ+ any relat$ s]vices    
recomm5d$ 9 curr5t ,unit$ ,/ates ,public
 ,heal? ,s]vice cl9ical practice        
guidel9es1 )\t limitation2 &  4  7g7    
,cov]age ( ,,hiv prev5tion treatm5t by  

,dep>tm5t ( ,def5se  7#a7 ,9 g5]al      
,*apt] #ee ( title #aj1 ,unit$ ,/ates   
,code1 is am5d$ by ins]t+ aft] section  
#ajgi;c ! foll[+ new section3  #ajgi;d4 
,cov]age ( ,,hiv prev5tion treatm5t  7a7
 ,9 g5]al ,! ,secret>y ( ,def5se %all   
ensure cov]age "u ! ,,tric>e program (  
,,hiv prev5tion treatm5t describ$ 9     
subsection 7b7 = any b5efici>y "u       
section #ajgd7;a7 ( ?is title4  7b7     
,,hiv prev5tion treatm5t describ$ ,,hiv 
prev5tion treatm5t describ$ 9 ?is       
subsection includes any prescription    
drug approv$ by ! ,food & ,drug         
,adm9i/ration = ! prev5tion ( ,,hiv     
acquisition1 laboratory & o!r diagno/ic 
proc$ures associat$ ) ! use ( su* drugs1
 & cl9ical foll[ up & monitor+1 includ+ 
any relat$ s]vices recomm5d$ 9 curr5t   
,unit$ ,/ates ,public ,heal? ,s]vice    
cl9ical practice guidel9es1 )\t         
limitation4  7c7 ,no co/-,%>+ ,not)/&+  
section #ajge1 #ajge;a1 or              
#ajgd;g7a77#f7 ( ?is title or any o!r   
provision ( law1 !re is no co/-%>+      

requirem5t = ,,hiv prev5tion treatm5t   
cov]$ "u ?is section4  4  7#b7 ,cl]ical 
am5dm5t ,! table ( sections at ! beg9n+ 
( su* *apt] is am5d$ by ins]t+ aft] !   
item relat+ to section #ajgi;c ! foll[+ 
new item3  #ajgi;d4 ,cov]age ( ,,hiv    
prev5tion treatm5t4  4  7h7 ,indian     
,heal? ,s]vice te/+1 monitor+1 &        
prescription drugs = ! prev5tion ( ,,hiv
 acquisition ,! ,indian ,heal? ,c>e     
,improvem5t ,act is am5d$ by ins]t+ aft]
 section #bbc 7#be ,u4,s4,c4 #afbav7 !  
foll[+3  #bbd4 ,te/+1 monitor+1 &       
prescription drugs = ! prev5tion ( ,,hiv
 acquisition  7a7 ,9 g5]al ,! ,secret>y1
 act+ ?r\gh ! ,s]vice1 ,indian tribes1 &
 tribal organizations1 %all provide     
fund+ = any prescription drug approv$ by
 ! ,food & ,drug ,adm9i/ration = !      
prev5tion ( ,,hiv acquisition1          
laboratory & o!r diagno/ic proc$ures    
associat$ ) ! use ( su* drugs1 & cl9ical
 foll[ up & monitor+1 includ+ any relat$
 s]vices recomm5d$ 9 curr5t ,unit$      
,/ates ,public ,heal? ,s]vice cl9ical   

practice guidel9es1 )\t limitation4  7b7
 ,au?orization ( appropriations ,!re are
 au?oriz$ to be appropriat$ to c>ry out 
?is section su* sums z may be necess>y4 
4  7i7 ,effective date ,! am5dm5ts made 
by subsections 7a71 7b71 7e71 7f71 7g71 
& 7h7 %all take effect ) respect to plan
 ye>s beg9n+ on or aft] ,janu>y #a1     
#bjba4  #d4 ,prohibition on d5ial (     
cov]age or increase 9 premiums ( life1  
disability1 or long-t]m c>e insurance = 
individuals tak+ m$ication = ! prev5tion
 ( ,,hiv acquisition  7a7 ,prohibition  
,not)/&+ any o!r provision ( law1 x %all
 be unlawful to-- 7#a7 decl9e or limit  
cov]age ( a p]son "u any life insurance 
policy1 disability insurance policy1 or 
long-t]m c>e insurance policy1 on acc\nt
 ( ! individual tak+ m$ication = !      
purpose ( prev5t+ ! acquisition ( ,,hiv2
  7#b7 preclude an individual f tak+    
m$ication = ! purpose ( prev5t+ !       
acquisition ( ,,hiv z a condition (     
receiv+ a life insurance policy1        
disability insurance policy1 or long-t]m

 c>e insurance policy2  7#c7 consid]    
:e!r an individual is tak+ m$ication = !
 purpose ( prev5t+ ! acquisition ( ,,hiv
 9 det]m9+ ! premium rate = cov]age (   
su* individual "u a life insurance      
policy1 disability insurance policy1 or 
long-t]m c>e insurance policy2 or  7#d7 
o!rwise discrim9ate 9 ! (f]+1 issuance1 
cancellation1 am\nt ( su* cov]age1      
price1 or any o!r condition ( a life    
insurance policy1 disability insurance  
policy1 or long-t]m c>e insurance policy
 = an individual1 bas$ solely & )\t any 
additional actu>ial risks ^u :e!r !     
individual is tak+ m$ication = ! purpose
 ( prev5t+ ! acquisition ( ,,hiv4  7b7  
,en=cem5t ,a ,/ate insurance regulator  
may take su* actions to en=ce subsection
 7a7 z are specifically au?oriz$ "u !   
laws ( su* ,/ate4  7c7 ,def9itions ,9   
?is section3 7#a7 ,disability insurance 
policy ,! t]m disability insurance      
policy means a contract "u :i* an entity
 promises to pay a p]son a sum ( money 9
 ! ev5t t an illness or injury result+ 9

 a disability prev5ts su* p]son f work+4
  7#b7 ,life insurance policy ,! t]m    
life insurance policy means a contract  
"u :i* an entity promises to pay a      
designat$ b5efici>y a sum ( money ^u !  
dea? ( ! insur$4  7#c7 ,long-t]m c>e    
insurance policy ,! t]m long-t]m c>e    
insurance policy means a contract = :i* 
! only insurance protection provid$ "u !
 contract is cov]age ( qualifi$ long-t]m
 c>e s]vices 7z def9$ 9 section         
#ggjb;,b7c7 ( ! ,int]nal ,rev5ue ,code (
 #aihf74  #e4 ,public education campaign
 ,"p ,p ( title ,,iii ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4 #bhj;g et  
seq47 is am5d$ by add+ at ! end !       
foll[+3  #cii,v-#g4 ,pre-exposure       
prophylaxis public education campaign   
7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! 
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 %all e/abli% a public    
heal? campaign = ! purpose ( educat+ !  
public on m$ication = ! prev5tion (     
,,hiv acquisition4  7b7 ,requirem5ts ,9 
c>ry+ out ?is section1 ! ,secret>y %all 

ensure cultural compet5cy & efficacy )9 
high-ne$ communities 9 :i* ,pr,e,p is   
und]utiliz$ by develop+ ! campaign 9    
collaboration ) organizations t are     
indig5\s to communities t are           
ov]repres5t$ 9 ! dome/ic ,,hiv epidemic1
 includ+ communities ( color & !        
lesbian1 gay1 bisexual1 transg5d]1 &    
que] community4 ,! ,secret>y %all ensure
 t ! campaign is design$ to increase    
aw>5ess ( ! safety & effectiv5ess (     
,pr,e,p1 ! recomm5d$ cl9ical practices =
 provid+ ,pr,e,p-relat$ cl9ical c>e1 & !
 local availability ( ,pr,e,p provid]s1 
& to c\nt] /igma associat$ ) ! use (    
,pr,e,p4  7c7 ,evaluation ( program ,!  
,secret>y %all develop measures to      
evaluate ! effectiv5ess ( activities    
conduct$ "u ?is section t are aim$ at   
r$uc+ disp>ities 9 access to ,pr,e,p &  
support+ ! local community4 ,su*        
measures %all evaluate community outrea*
 activities1 language s]vices1 work=ce  
cultural compet5ce1 & o!r areas z       
det]m9$ by ! ,secret>y4  7d7 ,pr,e,p ,9 

?is section1 ! t]m ,pr,e,p means any    
drug approv$ by ! ,food & ,drug         
,adm9i/ration = ! purpose ( pre-exposure
 prophylaxis ) respect to ,,hiv4  7e7   
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ su* sums z   
may be necess>y = ea* ( fiscal ye>s     
#bjba ?r\gh #bjbf4  4  #f4 ,pati5t      
confid5tiality ,! ,secret>y ( ,heal? &  
,human ,s]vices %all am5d ! regulations 
promulgat$ "u section #bfd7;c7 ( !      
,heal? ,insurance ,portability &        
,acc\ntability ,act ( #aiif 7#db        
,u4,s4,c4 #acbj;d-#b note71 z necess>y1 
to ensure t individuals are able to     
access ! b5efits describ$ 9 section     
#bgac7;a77#f7 "u a family plan )\t any  
o!r individual enroll$ 9 su* family     
plan1 includ+ a prim>y subscrib] ( or   
policyhold]1 be+ in=m$ ( su* use ( su*  
b5efits4  #g4 ,pre-exposure prophylaxis 
fund+  7a7 ,9 g5]al ,n lat] ?an #a ye>  
aft] ! date ( enactm5t ( ?is ,act1 !    
,secret>y ( ,heal? & ,human ,s]vices 79 
?is ,act ref]r$ to z ! ,secret>y7 %all  

e/abli% a program t provides grants to  
,/ates1 t]ritories1 & ,indian ,tribes = 
! e/abli%m5t & support ( pre-exposure   
prophylaxis 7ref]r$ to 9 ?is section z  
,pr,e,p7 programs1 or e/abli%es a       
program = provid+ ,f$]al fund+ directly 
to eligible entities )9 a ,/ate1        
t]ritory1 or ,indian ,tribal t]ritory1 9
 ! case ( a ,/ate1 t]ritory1 or ,indian 
,tribe t does n apply = su* a grant4    
7b7 ,grant program  7#a7 ,applications  
,to be eligible to receive a grant "u   
subsection 7a71 a ,/ate1 t]ritory1 or   
,indian ,tribe %all--  7,a7 submit an   
application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ a        
description ( h[ any funds aw>d$ w be   
us$ & a plan describ+ h[ any funds aw>d$
 w be us$ to increase access to ,pr,e,p 
= un9sur$ individuals & r$uce disp>ities
 9 access to ,pr,e,p2 &  7,b7 appo9t a  
,pr,e,p grant adm9i/rator to manage !   
program4  7#b7 ,use ( funds ,any ,/ate1 
,t]ritory ( ! ,unit$ ,/ates1 or ,indian 

,tribe t is aw>d$ funds "u subsection   
7a7 %all use su* funds = eligible       
,pr,e,p exp5ses4  7c7 ,f$]al program    
7#a7 ,9 g5]al ,9 ! case ( a ,/ate1      
t]ritory1 or ,indian ,tribe t does n    
submit an application "u subsection 7b71
 ! ,secret>y %all provide fund+ to any (
 ! foll[+1 )9 ! applicable ,/ate1       
t]ritory1 or ,indian ,tribal t]ritory3  
7,a7 ,f$]ally qualifi$ heal? c5t]s 7z   
def9$ 9 section #ahfa7;aa77#d7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7aa77#d774  7,b7 ,family plann+   
grantees 7o!r ?an ,/ates7 fund$ "u      
section #ajja ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj74  7,c7 ,rural
 heal? cl9ics 7z def9$ 9 section        
#ahfa7;aa77#b7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7aa77#b774    
7,d7 ,heal? facilities op]at$ by or     
pursuant to a contract ) ! ,indian      
,heal? ,s]vice4  7,e7 ,community-bas$   
organizations1 cl9ics1 hospitals1 & o!r 
heal? facilities t provide s]vices to   
individuals at risk = or liv+ ) ,,hiv4  

7,f7 ,nonpr(it private entities provid+ 
compreh5sive prim>y c>e to populations  
at risk ( ,,hiv1 includ+ fai?-bas$ &    
community-bas$ organizations4  7#b7 ,use
 ( funds ,any entity receiv+ fund+ "u   
p>agraph 7#a7 %all use su* funds =      
eligible ,pr,e,p exp5ses4  7d7 ,eligible
 ,pr,e,p exp5ses  7#a7 ,9 g5]al ,!      
,secret>y %all publi% a li/ ( exp5ses t 
qualify z eligible ,pr,e,p exp5ses =    
purposes ( ?is section4  7#b7           
,inclusions ,su* li/ %all include-- 7,a7
 any prescription drug approv$ by !     
,food & ,drug ,adm9i/ration = !         
prev5tion ( ,,hiv acquisition1          
laboratory & o!r diagno/ic proc$ures    
associat$ ) ! use ( su* drugs1 & cl9ical
 foll[ up & monitor+1 includ+ any relat$
 s]vices recomm5d$ 9 curr5t ,unit$      
,/ates ,public ,heal? ,s]vice cl9ical   
practice guidel9es1 )\t limitation2     
7,b7 outrea* & public education         
activities direct$ t[>d populations     
ov]repres5t$ 9 ! dome/ic ,,hiv epidemic 
t increase aw>5ess ab\t ! exi/5ce (     

,pr,e,p1 provide education ab\t access  
to & heal? c>e cov]age ( ,pr,e,p1 &     
c\nt] /igma associat$ ) ! use ( ,pr,e,p2
 &  7,c7 outrea* activities direct$ t[>d
 physicians & o!r provid]s t provide    
education ab\t ,pr,e,p4  7e7 ,report to 
,congress ,! ,secret>y %all1 9 ea* ( !  
fir/ #e ye>s beg9n+ "o ye> aft] ! date (
 ! enactm5t ( ?is ,act1 submit to       
,congress1 & make public on ! int]net   
website ( ,dep>tm5t ( ,heal? & ,human   
,s]vices1 a report on ! impact ( any    
grants provid$ to ,/ates1 t]ritories1 & 
,indian ,tribes = ! e/abli%m5t & support
 ( pre-exposure prophylaxis programs "u 
?is section4  7f7 ,au?orization (       
,appropriations ,!re are au?oriz$ to be 
appropriat$ to c>ry out ?is section     
#fj1jjj1jjj = ea* ( ! fir/ #e fiscal    
ye>s beg9n+ aft] ! date ( ! enactm5t (  
?is section4  #h4 ,cl>ification ,?is    
,act1 includ+ ! am5dm5ts made by ?is    
,act1 %all apply not)/&+ any o!r        
provision ( law1 includ+ ,public ,law   
#ajc-ada4  #i4 ,private "r ( action ,any

 p]son aggriev$ by a violation ( ?is    
,act1 includ+ ! am5dm5ts made by ?is    
,act1 may comm5ce a civil action 9 an   
appropriate ,unit$ ,/ates ,di/rict ,c\rt
 or o!r c\rt ( compet5t jurisdiction to 
obta9 relief z all[$ by law z ei!r an   
individual or memb] ( a class4 ,if !    
pla9tiff is ! prevail+ p>ty 9 su* an    
action1 ! c\rt %all ord] ! def5dant to  
pay ! co/s & reasonable attorney fees ( 
! pla9tiff4