any preauthorization requirements for a drug that is ther-
apeutically equivalent.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply beginning with respect 
to the first plan year beginning after the date of en-
actment of this section. 
(b) MEDICARE.— 
(1) COVERAGE OF HIV PREVENTION SERVICES 
UNDER PART B.— 
(A) COVERAGE.— 
(i) IN GENERAL.—Section 1861(s)(2) 
of the Social Security Act (42 U.S.C. 
1395x(s)(2)) is amended— 
(I) in subparagraph (JJ), by in-
serting ‘‘and’’ at the end; and 
(II) by adding at the end the fol-
lowing new subparagraph: 
‘‘(KK) HIV prevention services (as defined in 
subsection (nnn));’’. 
(ii) DEFINITION.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x) 
is amended by adding at the end the fol-
lowing new subsection: 
‘‘(nnn) HIV PREVENTION SERVICES.—The term 
‘HIV prevention services’ means— 
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‘‘(1) drugs or biologicals approved by the Food 
and Drug Administration for the prevention of HIV, 
including any such drug or biological approved for 
use as pre-exposure prophylaxis (commonly referred 
to as ‘PrEP’) or as post-exposure prophylaxis (com-
monly referred to as ‘PEP’); 
‘‘(2) administrative fees for such drugs and 
biologicals; 
‘‘(3) laboratory and other diagnostic procedures 
associated with the use of such drugs and 
biologicals; 
‘‘(4) counseling with respect to HIV prevention, 
including HIV risk assessment, HIV risk reduction, 
and medication adherence; and 
‘‘(5) clinical follow up and monitoring, including 
any related services recommended in current United 
States Public Health Service clinical practice guide-
lines, without limitation.’’. 
(B) ELIMINATION OF COINSURANCE.—Sec-
tion 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended— 
(i) by striking ‘‘and (HH)’’ and in-
serting ‘‘(HH)’’; and 
(ii) by inserting before the semicolon 
at the end the following: ‘‘, and (II) with 
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respect to HIV prevention services (as de-
fined in section 1861(nnn)), the amount 
paid shall be 100 percent of (i) except as 
provided in clause (ii), the lesser of the ac-
tual charge for the service or the amount 
determined under the fee schedule that ap-
plies to such services under this part, and 
(ii) in the case of such services that are 
covered OPD services (as defined in sub-
section (t)(1)(B)), the amount determined 
under subsection (t)’’. 
(C) EXEMPTION FROM PART B DEDUCT-
IBLE.—The first sentence of section 1833(b) of 
the Social Security Act (42 U.S.C. 1395l(b)) is 
amended— 
(i) by striking ‘‘, and (13)’’ and in-
serting ‘‘(13)’’; and 
(ii) by striking ‘‘1861(n)..’’ and in-
serting ‘‘1861(n), and (14) such deductible 
shall not apply with respect to HIV pre-
vention services (as defined in section 
1861(nnn)(1)).’’. 
(D) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to items 
and services furnished on or after January 1 of 
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the first calendar year beginning after the date 
of enactment of this section. 
(2) 
ELIMINATION
OF
COST-SHARING
FOR 
DRUGS FOR THE PREVENTION OF HIV UNDER PART 
D.— 
(A) IN
GENERAL.—Section 1860D–2 of 
the Social Security Act (42 U.S.C. 1395w– 
102(b)) is amended— 
(i) in subsection (b)— 
(I) in paragraph (1)(A), by strik-
ing ‘‘and (9)’’ and inserting ‘‘, (9), 
and (10)’’; 
(II) in paragraph (2)— 
(aa) in subparagraph (A), 
by striking ‘‘and (9)’’ and insert-
ing ‘‘, (9), and (10)’’; 
(bb) in subparagraph (C)(i), 
in the matter preceding subclause 
(I), by striking ‘‘and (9)’’ and in-
serting ‘‘(9), and (10)’’; and 
(cc) in subparagraph (D)(i), 
in the matter preceding subclause 
(I), by striking ‘‘and (9)’’ and in-
serting ‘‘(9), and (10)’’; 
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(III) in paragraph (3)(A), in the 
matter preceding clause (i), by strik-
ing ‘‘and (9)’’ and inserting ‘‘(9), and 
(10)’’; 
(IV) in paragraph (4)(A)(i), by 
striking ‘‘and (9)’’ and inserting ‘‘, 
(9), and (10)’’; and 
(V) by adding at the end the fol-
lowing new paragraph: 
‘‘(10) ELIMINATION
OF
COST-SHARING
FOR 
DRUGS FOR THE PREVENTION OF HIV.—With re-
spect to a covered part D drug that is for the pre-
vention of HIV— 
‘‘(A) the deductible under paragraph (1) 
shall not apply; and 
‘‘(B) there shall be no coinsurance or other 
cost-sharing under this part with respect to 
such drug.’’; and 
(ii) in subsection (c), by adding at the 
end the following new paragraph: 
‘‘(7) 
TREATMENT
OF
COST-SHARING
FOR 
DRUGS FOR THE PREVENTION OF HIV.—The cov-
erage is provided in accordance with subsection 
(b)(10).’’. 
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(B) CONFORMING AMENDMENTS TO COST- 
SHARING FOR LOW-INCOME INDIVIDUALS.—Sec-
tion 1860D–14(a) of the Social Security Act 
(42 U.S.C. 1395w–114(a)) is amended— 
(i) in paragraph (1)(D), in each of 
clauses (ii) and (iii), by striking ‘‘para-
graph (6)’’ and inserting ‘‘paragraphs (6) 
and (7)’’; 
(ii) in paragraph (2)— 
(I) in subparagraph (B), by 
striking ‘‘and (9)’’ and inserting ‘‘, 
(9), and (10)’’; 
(II) in subparagraph (D), by 
striking ‘‘paragraph (6)’’ and insert-
ing ‘‘paragraphs (6) and (7)’’; and 
(III) in subparagraph (E), by 
striking ‘‘paragraph (6)’’ and insert-
ing ‘‘paragraphs (6) and (7)’’; and 
(iii) by adding at the end the fol-
lowing new paragraph: 
‘‘(7) NO
APPLICATION
OF
COST-SHARING
OR 
DEDUCTIBLE FOR DRUGS FOR THE PREVENTION OF 
HIV.—With respect to a covered part D drug that is 
for the prevention of HIV— 
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‘‘(A) the deductible under section 1860D– 
2(b)(1) shall not apply; and 
‘‘(B) there shall be no cost-sharing under 
this section with respect to such drug.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply beginning 
with respect to the first plan year beginning 
after the date of enactment of this section. 
(c) MEDICAID AND CHIP.— 
(1) MEDICAID.— 
(A) IN GENERAL.—Section 1905 of the So-
cial Security Act (42 U.S.C. 1396d) is amend-
ed— 
(i) in subsection (a)(4)— 
(I) by striking ‘‘; and (D)’’ and 
inserting ‘‘; (D)’’; 
(II) by striking ‘‘; and (E)’’ and 
inserting ‘‘; (E)’’; 
(III) by striking ‘‘; and (F)’’ and 
inserting ‘‘; (F)’’; and 
(IV) by striking the semicolon at 
the end and inserting ‘‘; and (G) HIV 
prevention services;’’; and 
(ii) by adding at the end the following 
new subsection: 
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‘‘(ll) HIV PREVENTION SERVICES.—For purposes of 
subsection (a)(4)(G), the term ‘HIV prevention services’ 
means prescription drugs approved by the Food and Drug 
Administration for the prevention of HIV, including any 
such drug approved for use as pre-exposure prophylaxis 
(commonly referred to as ‘PrEP’) or as post-exposure pro-
phylaxis (commonly referred to as ‘PEP’), administrative 
fees for such drugs, laboratory and other diagnostic proce-
dures associated with the use of such drugs, counseling 
with respect to HIV prevention (including HIV risk as-
sessment, HIV risk reduction, and medication adherence), 
and clinical follow up and monitoring, including any re-
lated services recommended in current United States Pub-
lic Health Service clinical practice guidelines, without limi-
tation.’’. 
(B) NO COST-SHARING.—Title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) is 
amended— 
(i) in section 1916, by inserting ‘‘HIV 
prevention services described in section 
1905(a)(4)(G),’’ 
after 
‘‘section 
1905(a)(4)(C),’’ each place it appears; and 
(ii) in section 1916A(b)(3)(B), by 
adding at the end the following new clause: 
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‘‘(xv) HIV prevention services de-
scribed in section 1905(a)(4)(G).’’. 
(C) INCLUSION
IN
BENCHMARK
COV-
ERAGE.—Section 1937(b)(7) of the Social Secu-
rity Act (42 U.S.C. 1396u–7(b)(7)) is amend-
ed— 
(i) in the paragraph header, by insert-
ing ‘‘AND
HIV
PREVENTION
SERVICES’’ 
after ‘‘SUPPLIES’’; and 
(ii) by striking ‘‘includes for any indi-
vidual described in section 1905(a)(4)(C), 
medical assistance for family planning 
services and supplies in accordance with 
such section’’ and inserting ‘‘includes med-
ical assistance for HIV prevention services 
described in section 1905(a)(4)(G), and in-
cludes, for any individual described in sec-
tion 1905(a)(4)(C), medical assistance for 
family planning services and supplies in ac-
cordance with such section’’. 
(2) CHIP.— 
(A) IN GENERAL.—Section 2103 of the So-
cial Security Act (42 U.S.C. 1397cc), as 
amended by section 11405(b)(1) of Public Law 
117–169, is amended— 
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(i) in subsection (a), by striking ‘‘and 
(8)’’ and inserting ‘‘(8), and (13)’’; and 
(ii) in subsection (c), by adding at the 
end the following new paragraph: 
‘‘(13) HIV PREVENTION
SERVICES.—Regard-
less of the type of coverage elected by a State under 
subsection (a), the child health assistance provided 
for a targeted low-income child, and, in the case of 
a State that elects to provide pregnancy-related as-
sistance pursuant to section 2112, the pregnancy-re-
lated assistance provided for a targeted low-income 
pregnant woman (as such terms are defined for pur-
poses of such section), shall include coverage of HIV 
prevention services (as defined in section 1905(ll)).’’. 
(B) 
NO
COST-SHARING.—Section 
2103(e)(2) of the Social Security Act (42 
U.S.C. 1397cc(e)(2)) is amended by inserting 
‘‘HIV prevention services described in sub-
section (c)(13),’’ before ‘‘or for pregnancy-re-
lated assistance’’. 
(3) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by this sub-
section shall take effect on January 1 of the 
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first calendar year beginning after the date of 
enactment of this section. 
(B) DELAY PERMITTED IF STATE LEGISLA-
TION REQUIRED.—In the case of a State plan 
approved under title XIX or XXI of the Social 
Security Act which the Secretary of Health and 
Human Services determines requires State leg-
islation (other than legislation appropriating 
funds) in order for the plan to meet the addi-
tional requirements imposed by this section, the 
State plan shall not be regarded as failing to 
comply with the requirements of such title sole-
ly on the basis of the failure of the plan to meet 
such additional requirements before the 1st day 
of the 1st calendar quarter beginning after the 
close of the 1st regular session of the State leg-
islature that ends after the 1-year period begin-
ning with the date of the enactment of this sec-
tion. For purposes of the preceding sentence, in 
the case of a State that has a 2-year legislative 
session, each year of the session is deemed to 
be a separate regular session of the State legis-
lature. 
(d) FEDERAL EMPLOYEES HEALTH BENEFITS PRO-
GRAM.— 
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(1) IN
GENERAL.—Section 8904 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(c) Any health benefits plan offered under this chap-
ter shall include benefits for, and may not impose any 
cost-sharing requirements for, any prescription drug ap-
proved by the Food and Drug Administration for the pre-
vention of HIV, including any such drug approved for use 
as pre-exposure prophylaxis (commonly referred to as 
‘PrEP’) or as post-exposure prophylaxis (commonly re-
ferred to as ‘PEP’), administrative fees for such drugs, 
laboratory and other diagnostic procedures associated with 
the use of such drugs, counseling with respect to HIV pre-
vention (including HIV risk assessment, HIV risk reduc-
tion, and medication adherence), and clinical follow up and 
monitoring, including any related services recommended in 
current United States Public Health Service clinical prac-
tice guidelines, without limitation.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply beginning with respect 
to the first plan year beginning after the date of en-
actment of this section. 
Æ 
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