,,ii  #aag? ,,congress  #a/ ,session    
,s4 #cbie  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #a1 #bjba,ms4 
,smi? 7= h]self & ,ms4 ,klobu*>7        
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+s2   
s5se ( ,congress  7a7 ,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 #bjai1
 !re 7 #cf1cih 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      
#bjai1 approximately #ff p]c5t ( new    
,,hiv diagnoses 7 among gay & bisexual  
m51 #db p]c5t ( new ,,hiv diagnoses 7   

among ,black p1 & #bb 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 ab\t #ii p]c5t4 ,x r$uces !    
risk ( gett+ ,,hiv f injection drug use 
by at lea/ #gd p]c5t4  7#e7 ,_m         
individuals at risk ( exposure to ,,hiv 
d n use ,pr,e,p4 ,( ! approximately     
#a1ajj1jjj p 9 ! ,unit$ ,/ates :o c\ld  
b5efit f ,pr,e,p1 only #bc p]c5t1 or    
ne>ly #bhe1jjj individuals1 fill$       
prescriptions = ! drug 9 #bjai4  7#f7   
,pr,e,p usage is inconsi/5t across      
racial & g5d] l9es4 ,9 #bjai1 only #h   
p]c5t ( ,black_/,african ,am]ican & #ad 
p]c5t ( ,hispanic_/,lat9x p]sons :o 7   

eligible = ,pr,e,p 7 prescrib$ x1 comp>$
 to #fc p]c5t ( :ite p]sons4            
,additionally1 slightly less ?an #aj    
p]c5t ( wom5 eligible = ,pr,e,p receiv$ 
a prescription 9 #bjai4  7#g7 ,!re are  
curr5tly #b br& "n drugs & #a g5]ic drug
 approv$ by ! ,food & ,drug             
,adm9i/ration = ! use ( ,pr,e,p on a    
daily basis4 ,o!r types ( ,,hiv         
prev5tion treatm5ts1 includ+ a long-act+
 injectable1 :i* is curr5tly "u ,,fda   
review1 & long-act+ oral pills1         
implants1 & vag9al r+s are 9 ! rese>*   
pipel9e4 ,^! new innovations c increase 
widespread use ( ,pr,e,p along )        
adh]5ce1 :i* c spe$ ! ,nation's goal to 
end ,,hiv & address inequities 9 heal?  
c>e4  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 h to cov] ,pr,e,p 
= su* individuals )\t co/-%>+ effective 
,janu>y #bjba4  7#i7 ,jo9t guidance     
issu$ by ! ,dep>tm5t ( ,labor1 !        
,dep>tm5t ( ,heal? & ,human ,s]vices1 & 
! ,dep>tm5t ( ! ,treasury on ,july #ai1 
#bjba1 cl>ifies t ancill>y s]vices      
necess>y to ma9ta9 ! ,pr,e,p regime1    
includ+ subsequ5t provid] visits1       
cl9ical te/+1 & o!r s]vices1 is requir$ 
to be cov]$ by heal? insur]s )\t        
co/-%>+4  7#aj7 ,p]man5tly exp&+ access 
to co/-free ,pr,e,p & ancill>y s]vices =
 all individuals1 includ+ individuals :o
 d n h heal? insurance1 ?r\gh           
legislation1 is a critical /ep t[>ds    
elim9at+ ,,hiv transmission4  7#aa7     
,po/-exposure prophylaxis 7ref]r$ to 9  
?is section z ,,pep7 is a daily         
antiretroviral treatm5t :i*1 :5 initiat$
 promptly aft] a sexual or o!r exposure 

to blood or body fluids t is associat$ )
 a high risk ( ,,hiv transmission1 is   
highly effective at prev5t+ ,,hiv       
infection4  7#ab7 ,! ,c5t]s = ,disease  
,control & ,prev5tion recomm5ds ,,pep = 
an individual :o has exp]i5c$ a         
high-risk exposure incid5t1 provid$ t ! 
individual te/s ,,hiv-negative1         
initiates su* treatm5t no lat] ?an #gb  
h\rs aft] exposure1 & cont9ues !        
treatm5t = #bh days4  7#ac7 ,despite    
,,pep's prov5 effectiv5ess 9 prev5t+    
,,hiv infection aft] high-risk sexual   
exposures1 aw>5ess ( ,,pep is l[ among  
individuals :o w\ld b5efit f ! treatm5t4
 ,/udies sugge/ t aw>5ess ( ,,pep & ( ! 
importance ( its prompt initiation is   
p>ticul>ly l[ among "y gay & bisexual m5
 ( color1 transg5d] p]sons1 & wom5 ( all
 g5d] id5tities4  7#ad7 ,adequate k (   
guidel9es issu$ by ! ,c5t]s = ,disease  
,control & ,prev5tion = assess+         
indications = ,,pep & = initiat+ &      
su/a9+ ,,pep are l[ among heal? c>e     
provid]s & /aff4 ,because ,,pep is an   

em]g5cy int]v5tion1 insuffici5t k among 
provid]s & /aff 9 hospital em]g5cy      
rooms1 urg5t c>e c5t]s1 community heal? 
c5t]s1 & prim>y c>e physicians is (     
p>ticul> conc]n4  7#ae7 ,private &      
public heal? insurance plans & programs 
frequ5tly impose requirem5ts = cov]age (
 ,,pep1 includ+ pre-au?orization        
requirem5ts & requirem5ts to obta9 !    
m$ications ?r\gh designat$ specialty    
ph>macies & mail-ord] programs t pose   
significant ob/acles to timely          
initiation ( treatm5t4  7#af7 ,insurance
 d$uctibles & co-paym5ts = ,,pep        
m$ications create significant b>ri]s to 
,,pep utilization by _m individuals :o h
 exp]i5c$ high-risk incid5ts4  7b7 ,s5se
 ( ,congress ,x is ! s5se ( ,congress t 
! ,dep>tm5t ( ,labor1 ! ,dep>tm5t (     
,heal? & ,human ,s]vices1 & ! ,dep>tm5t 
( ! ,treasury %\ld ensure compliance ) !
 requirem5ts describ$ 9 p>agraphs 7#h7 &
 7#i7 ( subsection 7a74  #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 7o!r ?an a drug subject to        
preau?orization requirem5ts consi/5t )  
section #bgbi;,a71 adm9i/rative fees =  
su* drugs1 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  #bgbi;,a4 ,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               
preau?orization requirem5ts ) respect to
 cov]age ( ! s]vices describ$ 9 section 
#bgac7;a77#f71 except t a plan or issu] 
may impose preau?orization requirem5ts )
 respect to cov]age ( a p>ticul> drug   
approv$ "u section #eje7;c7 ( ! ,f$]al  
,food1 ,drug1 & ,cosmetic ,act or       
section #cea7;a7 ( ?is ,act if su* plan 
or issu] provides cov]age )\t any       
preau?orization requirem5ts = a drug t  
is !rapeutically equival5t4  4  7b7     
,cov]age "u ,f$]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 ( ,,hiv1    
adm9i/rative fees = su* drugs1          
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+ 2 &   
7,d7 & ins]t+ 2 7,d72  7ii7 by /rik+ 2 &
 7,e7 & ins]t+ 2 7,e72  7iii7 by /rik+ 2
 & 7,f7 & ins]t+ 2 7,f72 &  7iv7 by     
/rik+ ! semicolon at ! end & ins]t+ 2 & 
7,g7 ,,hiv prev5tion s]vices22 &  7,b7  
by add+ at ! end ! foll[+ new           
subsection3  7jj7 ,,hiv prev5tion       
s]vices ,= purposes ( subsection        
7a77#d77;,g71 ! t]m ,,hiv prev5tion     
s]vices means prescription drugs = !    
prev5tion ( ,,hiv acquisition1          
adm9i/rative fees = su* drugs1          

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;,g71 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   
7xii7 ,,hiv prev5tion s]vices describ$ 9
 section #aije7;a77#d77;,g74  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$-- 7,a7 9 ! p>agraph head]1 by     
ins]t+ & ,,hiv prev5tion s]vices aft]   
supplies2 &  7,b7 by /rik+ includes =   
any individual describ$ 9 section       
#aije7;a77#d77;,c71 m$ical assi/ance =  

family plann+ s]vices & supplies 9      
accordance ) su* section & ins]t+       
includes m$ical assi/ance = ,,hiv       
prev5tion s]vices describ$ 9 section    
#aije7;a77#d77;,g71 & includes1 = any   
individual describ$ 9 section           
#aije7;a77#d77;,c71 m$ical assi/ance =  
family plann+ s]vices & supplies 9      
accordance ) su* section4  7d7 ,,*ip    
7#a7 ,9 g5]al ,section #bajc ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acig;cc7
 is am5d$-- 7,a7 9 subsection 7a71 by   
/rik+ & 7#h7 & ins]t+ 7#h71 7#aj71      
7#aa71 & 7#ab72 &  7,b7 9 subsection    
7c71 by add+ at ! end ! foll[+ new      
p>agraph3  7#ab7 ,,hiv prev5tion s]vices
 ,reg>dless ( ! type ( cov]age elect$ by
 a ,/ate "u subsection 7a71 ! *ild heal?
 assi/ance provid$ = a t>get$ l[-income 
*ild1 &1 9 ! case ( a ,/ate t elects to 
provide pregnancy-relat$ assi/ance      
pursuant to section #baab1 !            
pregnancy-relat$ assi/ance provid$ = a  
t>get$ l[-income pregnant woman 7z su*  
t]ms are def9$ = purposes ( su*         

section71 %all include cov]age ( ,,hiv  
prev5tion s]vices 7z def9$ 9 section    
#aije7;jj774  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+     
,,hiv prev5tion s]vices describ$ 9      
subsection 7c77#ab71 be=e or =          
pregnancy-relat$ assi/ance4  7#c7       
,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 #bjbc4  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 ,cov]age & elim9ation ( co/-,%>+ "u 
,m$ic>e  7#a7 ,cov]age ( ,,hiv prev5tion
 s]vices "u "p ,b  7,a7 ,cov]age  7i7 ,9
 g5]al ,section #ahfa7s77#b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciex7s77#b77 is am5d$-- 7,i7 9        
subp>agraph 7,,gg71 by /rik+ & at ! end2
  7,,ii7 9 subp>agraph 7,,hh71 by /rik+ 
! p]iod at ! end & ins]t+ 2 &2 &        
7,,iii7 by add+ at ! end ! foll[+ new   
subp>agraph3  7,,ii7 ,,hiv prev5tion    
s]vices 7z def9$ 9 subsection 7lll772  4
  7ii7 ,def9ition ,section #ahfa ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is am5d$ by add+ at ! end !     
foll[+ new subsection3  7lll7 ,,hiv     

prev5tion s]vices ,! t]m ,,hiv prev5tion
 s]vices means-- 7#a7 drugs or          
biologicals approv$ by ! ,food & ,drug  
,adm9i/ration = ! prev5tion ( ,,hiv2    
7#b7 adm9i/rative fees = su* drugs2     
7#c7 laboratory & o!r diagno/ic         
proc$ures associat$ ) ! use ( su* drugs2
 &  7#d7 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$-- 7i7 by /rik+ &
 7,,dd7 & ins]t+ 7,,dd72 &  7ii7 by     
ins]t+ be=e ! semicolon at ! end !      
foll[+3 & 7,,ee7 ) respect to ,,hiv     
prev5tion s]vices 7z def9$ 9 section    
#ahfa7lll771 ! 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*$ule t   
applies to su* s]vices "u ?is "p1 & 7ii7
 9 ! case ( su* s]vices t are cov]$     

,,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#aa71 by /rik+ & at ! end2 &  7ii7 9   
p>agraph 7#ab71 by /rik+ ! p]iod at !   
end & ins]t+ 1 & 7#ac7 su* d$uctible    
%all n apply ) respect to ,,hiv         
prev5tion s]vices 7z def9$ 9 section    
#ahfa7lll7744  7,d7 ,effective date ,!  
am5dm5ts made by ?is p>agraph %all apply
 to items & s]vices furni%$ on or aft]  
,janu>y #a1 #bjbc4  7#b7 ,elim9ation (  
co/-,%>+ = drugs = ! prev5tion ( ,,hiv  
"u "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 ,elim9ation (
 co/-%>+ = drugs = ! prev5tion ( ,,hiv  
7,a7 ,9 g5]al ,= plan ye> #bjbc & 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 ( ,,hiv4  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$ication = !    
prev5tion ( ,,hiv4  4  7#b7 ,elim9ation 
( hospital c>e & m$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 ( ,,hiv1    
adm9i/rative fees = su* drugs1 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 ( ,,hiv1    
adm9i/rative fees = su* drugs1          
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 ( ,,hiv1    
adm9i/rative fees = su* drugs1          
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 (     
,,hiv1 adm9i/rative fees = su* drugs1   
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

 ,! ,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  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 ( human immunodefici5cy  
virus 7commonly kn[n z ,,hiv71          
adm9i/rative fees = su* a drug1         
laboratory & o!r diagno/ic proc$ures    
associat$ ) ! use ( su* a drug1 &       
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$ su* sums z may be necess>y  
to c>ry out ?is section4  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      
#bjbc4  #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 & po/-exposure prophylaxis  
education campaigns  7a7 ,public        
education campaign  7#a7 ,9 g5]al ,!    
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 9 consultation ) ! ,director ( ! ,(fice
 ( ,infecti\s ,disease & ,,hiv_/,,aids  
,policy1 %all e/abli% a public heal?    
campaign = ! purpose ( educat+ ! public 
on m$ication = ! prev5tion ( ,,hiv      
acquisition4  7#b7 ,requirem5ts ,9 c>ry+
 out ?is subsection1 ! ,secret>y %all   
ensure cultural compet5cy & efficacy )9 
high-ne$ communities 9 :i* ,pr,e,p or   
,,pep are 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,p & ,,pep1 ! recomm5d$ cl9ical    
practices = provid+ ,pr,e,p-relat$ &    
,,pep-relat$ cl9ical c>e1 & ! local     
availability ( ,pr,e,p & ,,pep provid]s1
 & to c\nt] /igma associat$ ) ! use (   
,pr,e,p & ,,pep4  7#c7 ,evaluation (    
program ,! ,secret>y %all develop       
measures to evaluate ! effectiv5ess (   
activities conduct$ "u ?is subsection t 
are aim$ at r$uc+ disp>ities 9 access to
 ,pr,e,p & ,,pep & support+ ! local     
community4 ,su* measures %all evaluate  
community outrea* activities1 language  
s]vices1 work=ce cultural compet5ce1 &  
o!r areas z det]m9$ by ! ,secret>y4  7b7
 ,provid] education campaign  7#a7 ,9   
g5]al ,! ,secret>y1 act+ ?r\gh !        

,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion & ! ,adm9i/ration ( !     
,heal? ,res\rces ,s]vices ,adm9i/ration 
& ! ,(fice ( ,infecti\s ,disease &      
,,hiv_/,,aids ,policy1 %all e/abli% a   
provid] campaign = ! purpose ( educat+  
prescrib]s & o!r associat$ heal?        
pr(essionals on m$ication = ! prev5tion 
( ,,hiv acquisition4  7#b7 ,requirem5ts 
,9 c>ry+ out ?is subsection1 ! ,secret>y
 %all increase aw>5ess & read9ess among 
heal? c>e provid]s to (f] ,pr,e,p or    
,,pep1 z appropriate1 ) a focus on areas
 ( high-ne$ communities 9 :i* ,pr,e,p or
 ,,pep is und]utiliz$ by develop+ an    
educational campaign ) input f heal? c>e
 provid]s & 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,p & ,,pep1 !     
recomm5d$ cl9ical practices = provid+   

,pr,e,p-relat$ & ,,pep-relat$ cl9ical   
c>e1 cultural compet5cy among ,pr,e,p & 
,,pep prescrib]s1 & to c\nt] /igma      
associat$ ) ! use ( ,pr,e,p & ,,pep4    
7#c7 ,evaluation ( program ,! ,secret>y 
%all develop measures to evaluate !     
effectiv5ess ( activities conduct$ "u   
?is subsection t are aim$ at increas+ ! 
numb] ( heal? c>e pr(essionals (f]+     
,pr,e,p & ,,pep & r$uc+ disp>ities 9    
access to ,pr,e,p & ,,pep4 ,su* measures
 %all evaluate availability ( ,pr,e,p & 
,,pep s]vices1 education & outrea*      
activities1 language s]vices1 work=ce   
cultural compet5ce1 & o!r areas z       
det]m9$ by ! ,secret>y4  7c7 ,def9itions
 ,9 ?is section & section #cii,v-#h--   
7#a7 ! t]m ,,pep means any drug or      
comb9ation ( drugs approv$ by ! ,food & 
,drug ,adm9i/ration = prev5t+ ,,hiv     
infection aft] a sexual or o!r exposure 
associat$ ) a high risk ( ,,hiv         
transmission2 &  7#b7 ! t]m ,pr,e,p     
means any drug approv$ by ! ,food &     
,drug ,adm9i/ration = ! purpose (       

pre-exposure prophylaxis ) respect to   
,,hiv4  7d7 ,au?orization (             
appropriations ,to c>ry out ?is section1
 !re are au?oriz$ to be appropriat$ su* 
sums z may be necess>y = ea* ( fiscal   
ye>s #bjbc ?r\gh #bjbh4  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 
& po/-exposure prophylaxis fund+ ,"p ,p 
( title ,,iii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bhj;g et seq471 z 
am5d$ by section #e1 is fur!r am5d$ by  
add+ at ! end ! foll[+3  #cii,v-#h4     
,pre-exposure prophylaxis & po/-exposure

 prophylaxis fund+  7a7 ,9 g5]al ,n lat]
 ?an #a ye> aft] ! date ( ! enactm5t ( !
 ,pr,e,p ,access & ,cov]age ,act1 !     
,secret>y %all e/abli% a program t aw>ds
 grants to ,/ates1 t]ritories1 ,indian  
,tribes1 & directly eligible entities = 
! e/abli%m5t & support ( pre-exposure   
prophylaxis 7ref]r$ to 9 ?is section z  
,pr,e,p7 & po/-exposure prophylaxis     
7ref]r$ to 9 ?is section z ,,pep7       
programs4  7b7 ,applications ,to be     
eligible to receive a grant "u          
subsection 7a71 a ,/ate1 t]ritory1      
,indian ,tribe1 or directly eligible    
entity %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 plan describ+ h[ 
any funds aw>d$ w be us$ to increase    
access to ,pr,e,p = un9sur$ & und]9sur$ 
individuals & r$uce disp>ities 9 access 
to ,pr,e,p & ,,pep = un9sur$ & und]9sur$
 individuals & r$uce disp>ities 9 access
 to ,pr,e,p & ,,pep2 &  7#b7 appo9t a   
,pr,e,p & ,,pep grant adm9i/rator to    

manage ! program4  7c7 ,directly        
eligible entity ,= purposes ( ?is       
section1 ! t]m directly eligible        
entity-- 7#a7 means a ,f$]ally qualifi$ 
heal? c5t] or o!r nonpr(it entity engag$
 9 provid+ ,pr,e,p & ,,pep in=mation &  
s]vices2 &  7#b7 may include-- 7,a7 a   
,f$]ally qualifi$ heal? c5t] 7z def9$ 9 
section #ahfa7;aa77#d7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciex7aa77#d7772  7,b7 a family plann+ 
grantee 7o!r ?an ,/ates7 fund$ "u       
section #ajja ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj72  7,c7 a     
rural heal? cl9ic 7z def9$ 9 section    
#ahfa7;aa77#b7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7aa77#b7772   
7,d7 a heal? facility op]at$ by or      
pursuant to a contract ) ! ,indian      
,heal? ,s]vice2  7,e7 a community-bas$  
organization1 cl9ic1 hospital1 or o!r   
heal? facility t provides s]vices to    
individuals at risk = or liv+ ) ,,hiv2 &
  7,f7 a nonpr(it private entity provid+
 compreh5sive prim>y c>e to populations 

at risk ( ,,hiv1 includ+ fai?-bas$ &    
community-bas$ organizations4  7d7      
,aw>ds ,9 det]m9+ :e!r to aw>d a grant1 
& ! grant am\nt = ea* grant aw>d$1 !    
,secret>y %all consid] ! grant          
application & ! ne$ = ,pr,e,p & ,,pep   
s]vices 9 ! area1 ! numb] ( un9sur$ &   
und]9sur$ individuals 9 ! area1 & h[ !  
,/ate1 t]ritory1 or ,indian ,tribe      
coord9ates ,pr,e,p & ,,pep activities ) 
! directly fund$ entity1 if ! ,/ate1    
t]ritory1 or ,indian ,tribe applies = ! 
funds4  7e7 ,use ( funds  7#a7 ,9 g5]al 
,any ,/ate1 t]ritory1 ,indian ,tribe1 or
 directly eligible entity t is aw>d$    
funds "u subsection 7a7 %all use su*    
funds = eligible ,pr,e,p & ,,pep        
exp5ses4  7#b7 ,eligible prep exp5ses ,!
 ,secret>y %all publi% a li/ ( exp5ses t
 qualify z eligible ,pr,e,p & ,,pep     
exp5ses = purposes ( ?is section1 :i*   
%all include-- 7,a7 any prescription    
drug approv$ by ! ,food & ,drug         
,adm9i/ration = ! prev5tion ( ,,hiv1    
adm9i/rative fees = su* drugs1          

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,p & ,,pep1 provide education ab\t 
access to & heal? c>e cov]age ( ,pr,e,p 
& ,,pep1 ,pr,e,p & ,,pep adh]5ce        
programs1 & c\nt] /igma associat$ ) !   
use ( ,pr,e,p & ,,pep2 &  7,c7 outrea*  
activities direct$ t[>d physicians & o!r
 provid]s t provide education ab\t      
,pr,e,p & ,,pep4  7f7 ,report to        
,congress ,! ,secret>y %all1 9 ea* ( !  
fir/ #e ye>s beg9n+ "o ye> aft] ! date (
 ! enactm5t ( ! ,pr,e,p ,access &       
,cov]age ,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
 & directly eligible entities = !       
e/abli%m5t & support ( pre-exposure     
prophylaxis programs "u ?is section4    
7g7 ,au?orization ( ,appropriations ,to 
c>ry out ?is section1 !re are au?oriz$  
to be appropriat$ su* sums z may be     
necess>y = ea* ( fiscal ye>s #bjbc ?r\gh
 #bjbh4  4  #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