1370 
programs for all inmates. HIV educational pro-
grams may be provided by community-based or-
ganizations, local health departments, and in-
mate peer educators. 
(B) HIV educational materials shall be 
made available to all inmates at orientation, at 
health care clinics, at regular educational pro-
grams, and prior to release. Both written and 
audiovisual materials shall be made available to 
all inmates. 
(C)(i) The HIV educational programs and 
materials under this paragraph shall include in-
formation on— 
(I) modes of transmission, including 
transmission through tattooing, sexual con-
tact, and intravenous drug use; 
(II) prevention methods; 
(III) treatment; and 
(IV) disease progression. 
(ii) The programs and materials shall be 
culturally sensitive, written or designed for low- 
literacy levels, available in a variety of lan-
guages, and present scientifically accurate in-
formation in a clear and understandable man-
ner. 
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(4) HIV TESTING UPON REQUEST.— 
(A) Health care personnel shall allow in-
mates to obtain HIV tests upon request once 
per year or whenever an inmate has a reason to 
believe the inmate may have been exposed to 
HIV. Health care personnel shall, both orally 
and in writing, inform inmates, during orienta-
tion and periodically throughout incarceration, 
of their right to obtain HIV tests. 
(B) Health care personnel shall encourage 
inmates to request HIV tests if the inmate is 
sexually active, has been raped, uses intra-
venous drugs, receives a tattoo, or if the inmate 
is concerned that the inmate may have been ex-
posed to HIV. 
(C) An inmate’s request for an HIV test 
shall not be considered an indication that the 
inmate has put themselves at risk of infection 
or committed a violation of prison rules. 
(5) HIV TESTING OF PREGNANT WOMAN.— 
(A) Health care personnel shall provide 
routine HIV testing to all inmates who become 
pregnant. 
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1372 
(B) All HIV tests under this paragraph 
shall comply with the opt-out provision under 
paragraph (9). 
(6) COMPREHENSIVE TREATMENT.— 
(A) Health care personnel shall provide all 
inmates who test positive for HIV— 
(i) 
timely, 
comprehensive 
medical 
treatment; 
(ii) confidential counseling on man-
aging their medical condition and pre-
venting its transmission to other persons; 
and 
(iii) voluntary partner notification 
services. 
(B) Health care provided under this para-
graph shall be consistent with Department of 
Health and Human Services guidelines and 
standard medical practice. Health care per-
sonnel shall discuss treatment options, the im-
portance of adherence to antiretroviral therapy, 
and the side effects of medications with inmates 
receiving treatment. 
(C) Health care personnel and pharmacy 
personnel shall ensure that the facility for-
mulary contains all Food and Drug Administra-
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1373 
tion-approved medications necessary to provide 
comprehensive treatment for inmates living with 
HIV, and that the facility maintains adequate 
supplies of such medications to meet inmates’ 
medical needs. Health care personnel and phar-
macy personnel shall also develop and imple-
ment automatic renewal systems for these medi-
cations to prevent interruptions in care. 
(D) Correctional staff, health care per-
sonnel, and pharmacy personnel shall develop 
and implement distribution procedures to en-
sure timely and confidential access to medica-
tions. 
(7) PROTECTION OF CONFIDENTIALITY.— 
(A) Health care personnel shall develop 
and implement procedures to ensure the con-
fidentiality of inmate tests, diagnoses, and 
treatment. Health care personnel and correc-
tional staff shall receive regular training on the 
implementation of these procedures. Penalties 
for violations of inmate confidentiality by health 
care personnel or correctional staff shall be 
specified and strictly enforced. 
(B) HIV testing, counseling, and treat-
ment shall be provided in a confidential setting 
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1374 
where other routine health services are provided 
and in a manner that allows the inmate to re-
quest and obtain these services as routine med-
ical services. 
(8) TESTING, COUNSELING, AND
REFERRAL 
PRIOR TO REENTRY.— 
(A) Health care personnel shall provide 
routine HIV testing to all inmates not earlier 
than 3 months prior to their release and re-
entry into the community. Inmates who are al-
ready known to be infected need not be tested 
again. This requirement may be waived if an in-
mate’s release occurs without sufficient notice 
to the Director to allow health care personnel to 
perform a routine HIV test and notify the in-
mate of the results. 
(B) All HIV tests under this paragraph 
shall comply with the opt-out provision. 
(C) To all inmates who test positive for 
HIV and all inmates who already are known to 
have HIV, health care personnel shall provide— 
(i) confidential prerelease counseling 
on managing their medical condition in the 
community, accessing appropriate treat-
ment and services in the community, and 
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1375 
preventing the transmission of their condi-
tion to family members and other persons 
in the community; 
(ii) referrals to appropriate health 
care providers and social service agencies 
in the community that meet the inmate’s 
individual needs, including voluntary part-
ner notification services and prevention 
counseling services for people living with 
HIV; and 
(iii) a 30-day supply of any medically 
necessary medications the inmate is cur-
rently receiving. 
(9) OPT-OUT PROVISION.—Inmates shall have 
the right to refuse routine HIV testing. Inmates 
shall be informed both orally and in writing of this 
right. Oral and written disclosure of this right may 
be included with other general health information 
and counseling provided to inmates by health care 
personnel. If an inmate refuses a routine test for 
HIV, health care personnel shall make a note of the 
inmate’s refusal in the inmate’s confidential medical 
records. However, the inmate’s refusal shall not be 
considered a violation of prison rules or result in dis-
ciplinary action. Any reference in this section to the 
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1376 
‘‘opt-out provision’’ shall be deemed a reference to 
the requirement of this paragraph. 
(10) EXCLUSION OF TESTS PERFORMED UNDER 
SECTION 4014(b) FROM THE DEFINITION OF ROU-
TINE
HIV
TESTING.—HIV testing of an inmate 
under section 4014(b) of title 18, United States 
Code, is not routine HIV testing for the purposes of 
the opt-out provision. Health care personnel shall 
document the reason for testing under section 
4014(b) of title 18, United States Code, in the in-
mate’s confidential medical records. 
(11) TIMELY
NOTIFICATION
OF
TEST
RE-
SULTS.—Health care personnel shall provide timely 
notification to inmates of the results of HIV tests. 
(g) CHANGES IN EXISTING LAW.— 
(1) SCREENING IN GENERAL.—Section 4014(a) 
of title 18, United States Code, is amended— 
(A) by striking ‘‘for a period of 6 months 
or more’’; 
(B) by striking ‘‘, as appropriate,’’; and 
(C) by striking ‘‘if such individual is deter-
mined to be at risk for infection with such virus 
in accordance with the guidelines issued by the 
Bureau of Prisons relating to infectious disease 
management’’ and inserting ‘‘unless the indi-
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1377 
vidual declines. The Attorney General shall also 
cause such individual to be so tested before re-
lease unless the individual declines.’’. 
(2) INADMISSIBILITY OF HIV TEST RESULTS IN 
CIVIL
AND
CRIMINAL
PROCEEDINGS.—Section 
4014(d) of title 18, United States Code, is amended 
by inserting ‘‘or under the Stop HIV in Prison Act’’ 
after ‘‘under this section’’. 
(3) SCREENING AS PART OF ROUTINE SCREEN-
ING.—Section 4014(e) of title 18, United States 
Code, is amended by adding at the end the fol-
lowing: ‘‘Such rules shall also provide that the initial 
test under this section be performed as part of the 
routine health screening conducted at intake.’’. 
(h) REPORTING REQUIREMENTS.— 
(1) REPORT ON HEPATITIS, LIVER, AND OTHER 
DISEASES.—Not later than 1 year after the date of 
enactment of this Act, the Director shall provide a 
report to the Congress on the policies and proce-
dures of the Bureau of Prisons to provide testing, 
treatment, and prevention education programs for 
hepatitis, liver failure, and other liver-related dis-
eases transmitted through sexual activity, intra-
venous drug use, or other means. The Director shall 
consult with appropriate officials of the Department 
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1378 
of Health and Human Services, the Office of Na-
tional Drug Control Policy, the Office of National 
AIDS Policy, and the Centers for Disease Control 
and Prevention regarding the development of this re-
port. 
(2) ANNUAL REPORTS.— 
(A) GENERALLY.—Not later than 2 years 
after the date of enactment of this Act, and 
then annually thereafter, the Director shall re-
port to Congress on the incidence among in-
mates of diseases transmitted through sexual 
activity and intravenous drug use. 
(B) MATTERS
PERTAINING
TO
VARIOUS 
DISEASES.—Each report under subparagraph 
(A) shall discuss— 
(i) the incidence among inmates of 
HIV, hepatitis, and other diseases trans-
mitted through sexual activity and intra-
venous drug use; and 
(ii) updates on the testing, treatment, 
and prevention education programs for 
these diseases conducted by the Bureau of 
Prisons. 
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1379 
(C) 
MATTERS
PERTAINING
TO
HIV 
ONLY.—Each report under subparagraph (A) 
shall also include— 
(i) the number of inmates who tested 
positive for HIV upon intake; 
(ii) the number of inmates who tested 
positive prior to reentry; 
(iii) the number of inmates who were 
not tested prior to reentry because they 
were released without sufficient notice; 
(iv) the number of inmates who opted 
out of taking the test; 
(v) the number of inmates who were 
tested under section 4014(b) of title 18, 
United States Code; and 
(vi) the number of inmates under 
treatment for HIV. 
(D) CONSULTATION.—The Director shall 
consult with appropriate officials of the Depart-
ment of Health and Human Services, the Office 
of National Drug Control Policy, and the Cen-
ters for Disease Control and Prevention regard-
ing the development of each report under sub-
paragraph (A). 
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1380 
SEC. 7219. TRANSFER OF FUNDS FOR IMPLEMENTATION OF 
ENDING THE HIV EPIDEMIC: A PLAN FOR 
AMERICA. 
Title II of the Public Health Service Act (42 U.S.C. 
202 et seq.) is amended by inserting after section 241 (42 
U.S.C. 238j) the following: 
‘‘SEC. 241A. TRANSFER OF FUNDS FOR IMPLEMENTATION 
OF NATIONAL HIV/AIDS STRATEGY. 
‘‘(a) TRANSFER AUTHORIZATION.—Of the discre-
tionary appropriations made available to the Department 
of Health and Human Services for any fiscal year for pro-
grams and activities that, as determined by the Secretary, 
pertain to HIV, the Secretary may transfer up to 1 per-
cent of such appropriations to the Office of the Assistant 
Secretary for Health for implementation of the Ending the 
HIV Epidemic: A Plan for America. 
‘‘(b) CONGRESSIONAL NOTIFICATION.—Not less than 
30 days before making any transfer under this section, 
the Secretary shall give notice of the transfer to the Con-
gress. 
‘‘(c) DEFINITIONS.—In this section, the term ‘End-
ing the HIV Epidemic: A Plan for America’ means the 
initiative of the Department of Health and Human Serv-
ices that seeks to reduce the number of new HIV infec-
tions in the United States by 75 percent by 2025, and 
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1381 
then by at least 90 percent by 2030, for an estimated 
250,000 total HIV infections averted.’’. 
SEC. 7220. PrEP ACCESS AND COVERAGE. 
(a) COVERAGE OF HIV TESTING AND PREVENTION 
SERVICES.— 
(1) PRIVATE INSURANCE.— 
(A) IN GENERAL.—Section 2713(a) of the 
Public Health Service Act (42 U.S.C. 300gg– 
13(a)) is amended— 
(i) in paragraph (2), by striking ‘‘; 
and’’ and inserting a semicolon; 
(ii) in paragraph (3), by striking the 
period and inserting a semicolon; 
(iii) in paragraph (4), by striking the 
period and inserting a semicolon; 
(iv) in paragraph (5), by striking the 
period and inserting ‘‘; and’’; and 
(v) by adding at the end the following: 
‘‘(6) any prescription drug approved by the 
Food and Drug Administration for the prevention of 
HIV (other than a drug subject to preauthorization 
requirements consistent with section 2729A), admin-
istrative fees for such drugs, laboratory and other 
diagnostic procedures associated with the use of 
such drugs, and clinical follow up and monitoring, 
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1382 
including any related services recommended in cur-
rent United States Public Health Service clinical 
practice guidelines, without limitation.’’. 
(B) PROHIBITION ON PREAUTHORIZATION 
REQUIREMENTS.—Subpart II of part A of title 
XXVII of the Public Health Service Act (42 
U.S.C. 300gg–11 et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 2729A. PROHIBITION ON PREAUTHORIZATION RE-
QUIREMENTS WITH RESPECT TO CERTAIN 
SERVICES. 
‘‘A group health plan or a health insurance issuer of-
fering group or individual health insurance coverage shall 
not impose any preauthorization requirements with re-
spect to coverage of the services described in section 
2713(a)(6), except that a plan or issuer may impose 
preauthorization requirements with respect to coverage of 
a particular drug approved under section 505(c) of the 
Federal Food, Drug, and Cosmetic Act or section 351(a) 
of this Act if such plan or issuer provides coverage without 
any preauthorization requirements for a drug that is ther-
apeutically equivalent.’’. 
(2) COVERAGE
UNDER
FEDERAL
EMPLOYEES 
HEALTH BENEFITS PROGRAM.—Section 8904 of title 
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1383 
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 approved 
by the Food and Drug Administration for the prevention 
of HIV, administrative fees for such drugs, laboratory and 
other diagnostic procedures associated with the use of 
such drugs, and clinical follow up and monitoring, includ-
ing any related services recommended in current United 
States Public Health Service clinical practice guidelines, 
without limitation.’’. 
(3) 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 
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1384 
(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: 
‘‘(jj) HIV PREVENTION SERVICES.—For purposes of 
subsection (a)(4)(G), the term ‘HIV prevention services’ 
means prescription drugs for the prevention of HIV acqui-
sition, administrative fees for such drugs, laboratory and 
other diagnostic procedures associated with the use of 
such drugs, and clinical follow up and monitoring, includ-
ing any related services recommended in current United 
States Public Health Service clinical practice guidelines, 
without limitation.’’. 
(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: 
‘‘(xii) HIV prevention services de-
scribed in section 1905(a)(4)(G).’’. 
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1385 
(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’’. 
(4) CHIP.— 
(A) IN GENERAL.—Section 2103 of the So-
cial Security Act (42 U.S.C. 1397cc) is amend-
ed— 
(i) in subsection (a), by striking ‘‘and 
(8)’’ and inserting ‘‘(8), (10), (11), and 
(12)’’; and 
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1386 
(ii) in subsection (c), by adding at the 
end the following new paragraph: 
‘‘(12) 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(jj)).’’. 
(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)(12),’’ before ‘‘or for pregnancy-re-
lated assistance’’. 
(C) EFFECTIVE DATE.— 
(i) IN
GENERAL.—Subject to clause 
(ii), the amendments made by paragraph 
(3) and this paragraph shall take effect on 
January 1, 2023. 
(ii) DELAY PERMITTED IF STATE LEG-
ISLATION
REQUIRED.—In the case of a 
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1387 
State plan approved under title XIX of the 
Social Security Act which the Secretary of 
Health and Human Services determines re-
quires State legislation (other than legisla-
tion appropriating funds) in order for the 
plan to meet the additional requirements 
imposed by this subsection, the State plan 
shall not be regarded as failing to comply 
with the requirements of such title solely 
on the basis of the failure of the plan to 
meet such additional requirements before 
the 1st day of the 1st calendar quarter be-
ginning after the close of the 1st regular 
session of the State legislature that ends 
after the 1-year period beginning with the 
date of the enactment of this Act. For pur-
poses of the preceding sentence, in the case 
of a State that has a 2-year legislative ses-
sion, each year of the session is deemed to 
be a separate regular session of the State 
legislature. 
(5) COVERAGE
AND
ELIMINATION
OF
COST- 
SHARING UNDER MEDICARE.— 
(A) COVERAGE OF HIV PREVENTION SERV-
ICES UNDER PART B.— 
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1388 
(i) COVERAGE.— 
(I) 
IN
GENERAL.—Section 
1861(s)(2) of the Social Security Act 
(42 U.S.C. 1395x(s)(2)) is amended— 
(aa) in subparagraph (GG), 
by striking ‘‘and’’ at the end; 
(bb) in subparagraph (HH), 
by striking the period at the end 
and inserting ‘‘; and’’; and 
(cc) by adding at the end 
the following new subparagraph: 
‘‘(II) HIV prevention services (as defined 
in subsection (lll));’’. 
(II) DEFINITION.—Section 1861 
of the Social Security Act (42 U.S.C. 
1395x) is amended by adding at the 
end the following new subsection: 
‘‘(LLL) HIV PREVENTION SERVICES.—The term 
‘HIV prevention services’ means— 
‘‘(1) drugs or biologicals approved by the Food 
and Drug Administration for the prevention of HIV; 
‘‘(2) administrative fees for such drugs; 
‘‘(3) laboratory and other diagnostic procedures 
associated with the use of such drugs; and 
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1389 
‘‘(4) clinical follow up and monitoring, including 
any related services recommended in current United 
States Public Health Service clinical practice guide-
lines, without limitation.’’. 
(ii) ELIMINATION OF COINSURANCE.— 
Section 1833(a)(1) of the Social Security 
Act (42 U.S.C. 1395l(a)(1)) is amended— 
(I) by striking ‘‘and (DD)’’ and 
inserting ‘‘(DD)’’; and 
(II) by inserting before the semi-
colon at the end the following: ‘‘and 
(EE) with respect to HIV prevention 
services 
(as 
defined 
in 
section 
1861(lll)), the amount paid shall be 
100 percent of (i) except as provided 
in clause (ii), the lesser of the actual 
charge for the service or the amount 
determined under the fee schedule 
that applies to such services under 
this part, and (ii) in the case of such 
services that are covered OPD serv-
ices 
(as 
defined 
in 
subsection 
(t)(1)(B)), the amount determined 
under subsection (t)’’. 
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1390 
(iii) EXEMPTION FROM PART B DE-
DUCTIBLE.—Section 1833(b) of the Social 
Security Act (42 U.S.C. 1395l(b)) is 
amended— 
(I) in paragraph (11), by striking 
‘‘and’’ at the end; and 
(II) in paragraph (12), by strik-
ing the period at the end and insert-
ing ‘‘, and (13) such deductible shall 
not apply with respect to HIV preven-
tion services (as defined in section 
1861(lll).’’. 
(iv) EFFECTIVE DATE.—The amend-
ments made by this subparagraph shall 
apply to items and services furnished on or 
after January 1, 2023. 
(B) ELIMINATION OF COST-SHARING FOR 
DRUGS FOR THE PREVENTION OF HIV UNDER 
PART D.— 
(i) IN
GENERAL.—Section 1860D– 
2(b) of the Social Security Act (42 U.S.C. 
1395w–102(b)) is amended— 
(I) in paragraph (1)(A), by strik-
ing ‘‘The coverage’’ and inserting 
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1391 
‘‘Subject to paragraph (8), the cov-
erage’’; 
(II) in paragraph (2)(A), by 
striking ‘‘and (D)’’ and inserting ‘‘and 
(D) and paragraph (8)’’; 
(III) in paragraph (3)(A), by 
striking ‘‘and (4)’’ and inserting ‘‘(4), 
and (8)’’; 
(IV) in paragraph (4)(A)(i), by 
striking ‘‘The coverage’’ and inserting 
‘‘Subject to paragraph (8), the cov-
erage’’; and 
(V) by adding at the end the fol-
lowing new paragraph: 
‘‘(8) ELIMINATION
OF
COST-SHARING
FOR 
DRUGS FOR THE PREVENTION OF HIV.— 
‘‘(A) IN GENERAL.—For plan year 2023 
and each subsequent plan year, there shall be 
no cost-sharing under this part (including 
under section 1814D–14) for covered part D 
drugs that are for the prevention of HIV. 
‘‘(B) COST-SHARING.—For purposes of 
subparagraph (A), the elimination of cost-shar-
ing shall include the following: 
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1392 
‘‘(i) NO
APPLICATION
OF
DEDUCT-
IBLE.—The waiver of the deductible under 
paragraph (1). 
‘‘(ii) NO
APPLICATION
OF
COINSUR-
ANCE.—The waiver of coinsurance under 
paragraph (2). 
‘‘(iii) NO
APPLICATION
OF
INITIAL 
COVERAGE
LIMIT.—The initial coverage 
limit under paragraph (3) shall not apply. 
‘‘(iv) NO
COST-SHARING
ABOVE
AN-
NUAL OUT-OF-POCKET THRESHOLD.—The 
waiver of cost-sharing under paragraph 
(4).’’. 
(ii) CONFORMING
AMENDMENTS
TO 
COST-SHARING FOR LOW-INCOME INDIVID-
UALS.—Section 1860D–14(a) of the Social 
Security Act (42 U.S.C. 1395w–114(a)) is 
amended— 
(I) in paragraph (1), in the mat-
ter preceding subparagraph (A), by 
striking ‘‘In the case’’ and inserting 
‘‘Subject to section 1860D–2(b)(8), in 
the case’’; and 
(II) in paragraph (2), in the mat-
ter preceding subparagraph (A), by 
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(CC) direct outreach to 
known environmental justice 
groups; 
(bb) public broadcast of that 
meeting, including soliciting and 
receiving comments by virtual 
means; and 
(cc) public availability of a 
transcript 
of 
that 
meeting 
through publication on an acces-
sible website. 
(III) LANGUAGES.—The Com-
mittee shall provide each notice, noti-
fication, direct outreach, broadcast, 
and transcript described in subclause 
(II) in each language commonly used 
in the applicable environmental justice 
community, including through oral in-
terpretation, if applicable. 
(iv) FUNDING.—Of amounts made 
available under subsection (f), the Admin-
istrator shall make available to the Com-
mittee such sums as are necessary for par-
ticipation by relevant stakeholders in pub-
lic engagement under this paragraph, as 
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