,,ii  #aai? ,,congress  #b;d ,session   
,s4 #ciij  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #d1 #bjbf,ms4     
,smi? 7= h]self1 ,mr4 ,s*iff1 ,ms4      
,alsobrooks1 ,ms4 ,baldw91 ,mr4         
,blum5?al1 ,mr4 ,book]1 ,mr4 ,coons1    
,ms4 ,cortez ,ma/o1 ,ms4 ,duckwor?1 ,mr4
 ,kim1 ,ms4 ,klobu*>1 ,mr4 ,m>key1 ,mr4 
,m]kley1 ,mr4 ,padilla1 ,mr4 ,re$1 ,ms4 
,ros51 ,mrs4 ,%ahe51 ,ms4 ,w>r51 ,mr4   
,wyd51 & ,mr4 ,hick5loop]7 introduc$ !  
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    
,act ( #bjbf4  #b4 ,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 ?is ,act4  #c4 ,cov]age      
requirem5ts  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$--   
7,a7 9 p>agraph 7#b71 by /rik+ 2 & &    
ins]t+ a semicolon2  7,b7 9 p>agraph    
7#c71 by /rik+ ! p]iod & ins]t+ a       
semicolon2  7,c7 9 p>agraph 7#d71 by    
/rik+ ! p]iod & ins]t+ 2 &2  7,d7 by    
/rik+ p>agraph 7#e72  7,e7 by add+ at ! 
end ! foll[+3  7#e7 any prescription    
drug approv$ by ! ,food & ,drug         
,adm9i/ration us$ = ! prev5tion ( ,,hiv 
7o!r ?an a drug subject to              
preau?orization requirem5ts consi/5t )  
section #bgbi;,a-#aa71 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     
includ+ policy notes updat+ ^?          
guidel9es1 )\t limitation4  2 &  7,f7 by
 add+ at ! end ( ! flu% text at ! end ! 
foll[+3 ,= ! purposes ( ?is ,act1 & = ! 

purposes ( any o!r provision ( law1 !   
curr5t recomm5dations ( ! ,unit$ ,/ates 
,prev5tive ,s]vice ,task ,=ce reg>d+    
brea/ canc] scre5+1 mammography1 &      
prev5tion %all be consid]$ ! mo/ curr5t 
o!r ?an ^? issu$ 9 or ar\nd ,novemb]    
#bjji44  7#b7 ,gr&fa!r$ plans ,section  
#abea7;a77#d7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjaa7;a77#d77 is am5d$ by add+ at !   
end ! foll[+3  7v7 ,section             
#bgac7;a77#e7 7relat+ to cov]age )\t    
co/-%>+ = prescription drugs = !        
prev5tion ( ,,hiv74  4  7#c7            
,prohibition on preau?orization         
requirem5ts  7,a7 ,,phsa ,"p ,d ( title 
,,xxvii ( ! ,public ,heal? ,s]vice ,act 
7#db ,u4,s4,c4 #cjj;gg-#aaa et seq47 is 
am5d$ by add+ at ! end ! foll[+3        
#bgii;,a-#ab4 ,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#e71 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$]al ,food1      
,drug1 & ,cosmetic ,act or section      
#cea7;a7 ( ?is ,act if su* plan or issu]
 provides cov]age )\t any               
preau?orization requirem5ts = a drug t  
is !rapeutically equival5t4  4  7,b7    
,,erisa  7i7 ,9 g5]al ,subp>t ,b ( "p #g
 ( subtitle ,b ( title ,i ( ! ,employee 
,retirem5t ,income ,security ,act (     
#aigd 7#bi ,u4,s4,c4 #aahe et seq47 is  
am5d$ by add+ at ! end ! foll[+3  #gbg4 
,prohibition on preau?orization         
requirem5ts ) respect to c]ta9 s]vices  
,a gr\p heal? plan or a heal? insurance 
issu] (f]+ gr\p heal? insurance cov]age 
%all n impose any preau?orization       
requirem5ts ) respect to cov]age ( !    
s]vices describ$ 9 section #bgac7;a77#e7
 ( ! ,public ,heal? ,s]vice ,act1 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$]al ,food1      
,drug1 & ,cosmetic ,act or section      
#cea7;a7 ( ! ,public ,heal? ,s]vice ,act
 if su* plan or issu] provides cov]age  
)\t any preau?orization requirem5ts = a 
drug t is !rapeutically equival5t4  4   
7ii7 ,cl]ical am5dm5t ,! table ( cont5ts
 9 section #a ( ! ,employee ,retirem5t  
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #ajja et seq47 is am5d$ by    
ins]t+ aft] ! item relat+ to section    
#gbf ! foll[+ new item3  ,sec4 #gbg4    
,prohibition on preau?orization         
requirem5ts ) respect to c]ta9 s]vices4 
4  7,c7 ,,irc  7i7 ,9 g5]al ,*apt] #ajj 
( ! ,int]nal ,rev5ue ,code ( #aihf is   
am5d$ by add+ at ! end ( sub*apt] ,b !  
foll[+3  #ihbg4 ,prohibition on         
preau?orization requirem5ts ) respect to
 c]ta9 s]vices ,a gr\p heal? plan %all n
 impose any preau?orization requirem5ts 
) respect to cov]age ( ! s]vices        
describ$ 9 section #bgac7;a77#e7 ( !    

,public ,heal? ,s]vice ,act1 except t a 
plan may impose preau?orization         
requirem5ts ) respect to cov]age ( a    
p>ticul> drug approv$ "u section        
#eje7;c7 ( ! ,f$]al ,food1 ,drug1 &     
,cosmetic ,act or section #cea7;a7 ( !  
,public ,heal? ,s]vice ,act if su* plan 
provides cov]age )\t any preau?orization
 requirem5ts = a drug t is !rapeutically
 equival5t4  4  7ii7 ,cl]ical am5dm5t ,!
 table ( sections = sub*apt] ,b ( *apt] 
#ajj ( ! ,int]nal ,rev5ue ,code ( #aihf 
is am5d$ by add+ at ! end ! foll[+ new  
item3 ,sec4 #ihbg4 ,prohibition on      
preau?orization requirem5ts ) respect to
 c]ta9 s]vices44  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 = any prescription drug     
approv$ by ! ,food & ,drug ,adm9i/ration
 us$ = ! 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 includ+ policy notes updat+  
^? guidel9es1 )\t limitation4  4  7c7   
,m$icaid  7#a7 ,9 g5]al ,section #aije (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acif;d7 is am5d$ by-- 7,a7 9          
subsection 7a77#d71 by /rik+ ! semicolon
 at ! end & ins]t+ 2 & 7,g7 ,,hiv       
prev5tion s]vices22 &  7,b7 by add+ at !
 end ! foll[+ new subsection3  7ll7     
,,hiv prev5tion s]vices ,= purposes (   
subsection 7a77#d77;,g71 ! t]m ,,hiv    
prev5tion s]vices means all prescription
 drugs us$ = ! 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 includ+     
policy notes updat+ ^? guidel9es )\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   
7xv7 ,,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 9 !  
matt] prec$+ p>agraph 7#a71 by /rik+ &  
7#h7 & ins]t+ 7#h71 & 7#ac72 &  7,b7 9  
subsection 7c71 by add+ at ! end !      
foll[+ new p>agraph3  7#ac7 ,,hiv       
prev5tion s]vices ,reg>dless ( ! type ( 
cov]age elect$ 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 #aije7ll774  4  7#b7 ,no
 co/-%>+ ,section #bajc7;e77#b7 ( !     

,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc7e77#b77 is am5d$-- 7,a7 9 !    
p>agraph head+1 by ins]t+ ,,hiv         
prev5tion s]vices1 aft] treatm5t12 &    
7,b7 by ins]t+ ,,hiv prev5tion s]vices  
describ$ 9 subsection 7c77#ac71 be=e or 
= pregnancy-relat$ assi/ance4  7#c7     
,effective date  7,a7 ,9 g5]al ,subject 
to subp>agraph 7,b71 ! am5dm5ts made by 
subsection 7c7 & ?is subsection %all    
take effect on ,janu>y #a1 #bjbg4  7,b7 
,delay p]mitt$ if ,/ate legislation     
requir$ ,9 ! case ( a ,/ate plan approv$
 "u title ,,xix or ,,xxi ( ! ,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,,jj71 by /rik+ & at ! end2
  7,,ii7 9 subp>agraph 7,,kk71 by ins]t+
 & at ! end2 &  7,,iii7 by add+ at ! end
 ! foll[+ new subp>agraph3  7,,ll7 ,,hiv
 prev5tion s]vices 7z def9$ 9 subsection
 7ooo772  4  7ii7  ,def9ition  ,section 
#ahfa ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciex7 is am5d$ by add+ at ! 
end ! foll[+ new subsection3  7ooo7     
,,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     
includ+ policy notes updat+ ^?          
guidel9es1 )\t limitation4  4  7,b7     
,elim9ation ( co9surance  ,section      
#ahcc7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciel7a77#a77 is       
am5d$--  7i7 by /rik+ & 7,,hh7 & ins]t+ 
7,,hh72 &  7ii7 by ins]t+ be=e !        
semicolon at ! end ! foll[+3 1 & 7,,ii7 
) respect to ,,hiv prev5tion s]vices 7z 
def9$ 9 section #ahfa7ooo771 ! 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$uctible  ,! fir/  
s5t5ce ( section #ahcc7;b7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4 #aciel7b77
 is am5d$--  7i7 by /rik+ 1 & 7#ac7 &   
ins]t+ 7#ac72 &  7ii7 by /rik+          
#ahfa7n744 & ins]t+ #ahfa7n71 & 7#ad7   
su* d$uctible %all n apply ) respect to 
,,hiv prev5tion s]vices 7z def9$ 9      
section #ahfa7ooo77#a7744  7,d7         
,effective date  ,! am5dm5ts made by ?is
 p>agraph %all apply to items & s]vices 
furni%$ on or aft] ,janu>y #a1 #bjbg4   
7#b7  ,elim9ation ( co/-%>+ = drugs = ! 
prev5tion ( ,,hiv "u "p ,d  7,a7  ,9    
g5]al  ,section #ahfj;,d-#b ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7 is am5d$--  7i7 9          
subsection 7b7-- 7,i7 9 p>agraph        
7#a77;,a71 by /rik+ & 7#i7 & ins]t+ 1   
7#i71 & 7#aj72  7,,ii7 9 p>agraph 7#b7--
 7aa7 9 subp>agraph 7,a71 by /rik+ &    
7#i7 & ins]t+ 1 7#i71 & 7#aj72  7bb7 9  
subp>agraph 7,c77i71 9 ! matt] prec$+   
subclause 7,i71 by /rik+ & 7#i7 & ins]t+

 7#i71 & 7#aj72 &  7cc7 9 subp>agraph   
7,d77i71 9 ! matt] prec$+ subclause     
7,i71 by /rik+ & 7#i7 & ins]t+ 7#i71 &  
7#aj72  7,,iii7 9 p>agraph 7#c77;,a71 9 
! matt] prec$+ clause 7i71 by /rik+ &   
7#i7 & ins]t+ 7#i71 & 7#aj72  7,,iv7 9  
p>agraph 7#d77;,a77i71 by /rik+ & 7#i7 &
 ins]t+ 1 7#i71 & 7#aj72 &  7,v7 by add+
 at ! end ! foll[+ new p>agraph3  7#aj7 
,elim9ation ( co/-%>+ = drugs = !       
prev5tion ( ,,hiv ,= plan ye>s beg9n+ on
 or aft] ,janu>y #a1 #bjbg1 ) respect to
 a cov]$ "p ,d drug t is = ! prev5tion (
 ,,hiv--  7,a7 ! d$uctible "u p>agraph  
7#a7 %all n apply2 &  7,b7 !re %all be  
no co9surance or o!r co/-%>+ "u ?is "p )
 respect to su* drug4  2 &  7ii7 9      
subsection 7c71 by add+ at ! end !      
foll[+ new p>agraph3  7#g7 ,treatm5t (  
co/-%>+ = drugs = ! prev5tion ( ,,hiv ,!
 cov]age is provid$ 9 accordance )      
subsection 7b77#aj74  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$--  7i7 9     
p>agraph 7#a77;,d71 9 ea* ( clauses 7ii7
 & 7iii71 by /rik+ p>agraph 7#f7 &      
ins]t+ p>agraphs 7#f7 & 7#g72  7ii7 9   
p>agraph 7#b7-- 7,i7 9 subp>agraph 7,b71
 by /rik+ & 7#i7 & ins]t+ 1 7#i71 &     
7#aj72  7,,ii7 9 subp>agraph 7,d71 by   
/rik+ p>agraph 7#f7 & ins]t+ p>agraphs  
7#f7 & 7#g72 &  7,,iii7 9 subp>agraph   
7,e71 by /rik+ p>agraph 7#f7 & ins]t+   
p>agraphs 7#f7 & 7#g72 &  7iii7 by add+ 
at ! end ! foll[+ new p>agraph3  7#g7   
,no application ( co/-%>+ or d$uctible =
 drugs = ! prev5tion ( ,,hiv ,= plan    
ye>s beg9n+ on or aft] ,janu>y #a1      
#bjbg1 ) respect to a cov]$ "p ,d drug t
 is = ! prev5tion ( ,,hiv--  7,a7 !     
d$uctible "u section #ahfj;,d-#b7;b77#a7
 %all n apply2 &  7,b7 !re %all be no   
co/-%>+ "u ?is section ) respect to su* 
drug4  4  7f7 ,cov]age ( ,,hiv prev5tion
 treatm5t by ,dep>tm5t ( ,vet]ans       
,affairs  7#a7 ,elim9ation ( m$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 & us$ = ! prev5tion 
( ,,hiv1 adm9i/rative fees = su* a drug1
 or cl9ical foll[-up & monitor+1 includ+
 any relat$ s]vices recomm5d$ 9 curr5t  
,unit$ ,/ates ,public ,heal? ,s]vice    
cl9ical practice guidel9es1 includ+     
policy notes updat+ ^? 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 & us$ = ! prev5tion (     
,,hiv1 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 includ+     
policy notes updat+ ^? 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 & us$ = ! prev5tion 
( ,,hiv1 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 includ+     
policy notes updat+ ^? 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 #ajgdo ! foll[+ 
new section3  #ajgdp4 ,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 & us$ = ! prev5tion 
( ,,hiv1 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 includ+     

policy notes updat+ ^? 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 #ajgdo ! foll[+  
new item3  #ajgdp4 ,cov]age ( ,,hiv     
prev5tion treatm5t4  4  7h7 ,indian     
,heal? ,s]vice te/+1 monitor+1 &        
prescription drugs = ! prev5tion ( ,,hiv
 ,title ,,ii ( ! ,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 
! ,director ( ,,hiv_/,,aids ,prev5tion &
 ,treatm5t "u section #hcb1 %all        
provide1 )\t limitation1 fund+ = any    
prescription drug approv$ by ! ,food &  
,drug ,adm9i/ration = ! prev5tion (     

human immunodefici5cy virus 7commonly   
kn[n z ,,hiv71 adm9i/rative fees = t    
drug1 laboratory & o!r diagno/ic        
proc$ures associat$ ) ! use ( t drug1 & 
cl9ical foll[-up & monitor+1 includ+ any
 relat$ s]vices recomm5d$ 9 curr5t      
,public ,heal? ,s]vice cl9ical practice 
guidel9es1 includ+ policy notes updat+  
^? guidel9es4  7b7 ,au?orization (      
appropriations ,!re are au?oriz$ to be  
appropriat$ su* sums z are 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 #bjbg4  #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 ( an individual "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-#h4 ,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
 & ,prev5tion1 ! ,adm9i/rator ( ! ,heal?
 ,res\rces & ,s]vices ,adm9i/ration1 & !
 ,(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 f communities 
t are disproportionately affect$ by !   
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-#i--   
7#a7 ! t]m ,,pep means any drug or      
comb9ation ( drugs approv$ by ! ,food & 
,drug ,adm9i/ration = prev5t+ ,,hiv     
transmission 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 #bjbf ?r\gh #bjcj4  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#e7 "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 ,pr,e,p & ,,pep 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-#i4 ,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 
,act ( #bjbf1 ! ,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$uce          
disp>ities 9 access to ,pr,e,p & ,,pep2 
&  7#b7 appo9t a ,pr,e,p & ,,pep grant  
adm9i/rator to manage ! program4  7c7   
,directly eligible entity ,= purposes ( 
?is section1 ! t]m directly eligible    
entity-- 7#a7 means a nonpr(it entity   
engag$ 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 ,act72  7,b7 a    
family plann+ grantee 7o!r ?an ,/ates7  

fund$ "u section #ajja2  7,c7 a rural   
heal? cl9ic 7z def9$ 9 section          
#ahfa7;aa77#b7 ( ! ,social ,security    
,act72  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 us$ = ! 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 includ+ policy notes
 updat+ ^? 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 & ,,pep2 &  7,d7 adh]5ce s]vices
 & c\nsel+1 includ+ p]sonnel co/s =     
,pr,e,p navigators to reta9 pati5ts 9   
c>e4  7f7 ,report to ,congress ,!       
,secret>y %all1 9 ea* ( ! fir/ #e ye>s  
beg9n+ #a ye> aft] ! date ( enactm5t ( !
 ,pr,e,p ,access & ,cov]age ,act (      
#bjbf1 submit to ,congress1 & make      
public on ! website ( ,dep>tm5t ( ,heal?
 & ,human ,s]vices1 a report on ! impact
 ( any grants provid$ to ,/ates1        
t]ritories1 ,indian ,tribes1 & 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 #bjbf ?r\gh #bjcj4  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  #aj4       
,en=cem5t  7a7 ,9 g5]al ,! ,secret>y (  
,heal? & ,human ,s]vices1 9 consultation
 ) ! ,c5t]s = ,disease ,control &       
,prev5tion1 %all-- 7#a7 issue guidance  
reg>d+ ! implem5tation ( ! cov]age      
requirem5ts e/abli%$ "u ?is ,act1       
includ+ ! am5dm5ts made by ?is ,act1    
includ+ ) respect to implem5tation ( su*
 cov]age requirem5ts2  7#b7 develop &   
dissem9ate educational mat]ials1 includ+
 bill+ & cod+ docum5ts bas$ on /akehold]
 cons5sus-driv5 recomm5dations1 z       

appropriate2  7#c7 provide te*nical     
assi/ance to ,/ate insurance            
commission]s2  7#d7 provide te*nical    
assi/ance to eligible entities reg>d+   
respond+ to consum] compla9ts & assi/+ 9
 resolv+ su* compla9ts2 &  7#e7 "w ) o!r
 ,f$]al ag5cies to assi/ 9 en=cem5t &   
compliance4  7b7 ,compliance  7#a7 ,9   
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices1 ! ,secret>y ( ,labor1 & !     
,secret>y ( ! ,treasury1 9 consultation 
) ! ,director ( ! ,c5t]s = ,disease     
,control & ,prev5tion1 %all monitor     
compliance by gr\p heal? plans & heal?  
insurance issu]s ) cov]age requirem5ts  
e/abli%$ "u sections #bgii;,a-#aa ( !   
,public ,heal? ,s]vice ,act1 #gbf ( !   
,employee ,retirem5t ,income ,security  
,act ( #aigd1 & #ihbf ( ! ,int]nal      
,rev5ue ,code ( #aihf 7z add$ by section
 #c7;a77 & %all take appropriate        
en=cem5t actions "u su* ,acts & su*     
,code4  7#b7 ,insur] submissions to !   
,secret>y ,beg9n+ n lat] ?an #a ye> aft]
 ! date ( enactm5t ( ?is ,act1 ea* gr\p 

heal? plan & heal? insurance issu] (f]+ 
gr\p or individual heal? insurance      
cov]age %all submit to ! ,secret>y (    
,heal? & ,human ,s]vices1 at su* "t z   
su* secret>y1 9 coord9ation ) !         
,secret>y ( ,labor & ! ,secret>y ( !    
,treasury1 %all require1 b n less       
frequ5tly ?an annually = ! #aj-ye> p]iod
 beg9n+ on su* date ( enactm5t1 data    
demon/rat+ compliance ) ! cov]age       
requirem5ts describ$ 9 p>agraph 7#a71   
includ+ aggregate data on ! numb] (     
claims receiv$ by su* plans & issu]s =  
,,hiv prev5tion s]vices & ! co/-%>+ =   
enrollees ) respect to su* claims4  7#c7
 ,reports to ,congress ,n lat] ?an #b   
ye>s aft] ! date ( enactm5t ( ?is ,act &
 e #b ye>s !reaft] = ! #aj-ye> p]iod    
beg9n+ on su* date ( enactm5t1 !        
,secret>y ( ,heal? & ,human ,s]vices1 ! 
,secret>y ( ,labor1 & ! ,secret>y ( !   
,treasury 7collectively ref]r$ to 9 ?is 
section z ! ,secret>ies7 %all jo9tly    
submit to ,congress & make publicly     
available a report to assess ! preval5ce

 ( noncompliance ) ! cov]age requirem5ts
 describ$ 9 p>agraph 7#a74 ,ea* su*     
report %all include-- 7,a7 aggregate    
in=mation ab\t gr\p heal? plans & heal? 
insurance issu]s t ! ,secret>ies det]m9e
 to be out ( compliance ) su*           
requirem5ts2 &  7,b7 /eps ! ,secret>ies 
h tak5 to address incid5ces ( su*       
noncompliance4  7#d7 ,def9itions ,9 ?is 
subsection1 ! t]ms gr\p heal? plan1     
heal? insurance cov]age1 & heal?        
insurance issu] h ! mean+s giv5 su* t]ms
 9 section #bgia ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#ia74