Sec. 3. Coverage of HIV testing and prevention services

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Section 2713(a) of the Public Health Service Act ( 42 U.S.C. 300gg–13(a) ) is amended— in paragraph (2), by striking ; and and inserting a semicolon; in paragraph (3), by striking the period and inserting a semicolon; in paragraph (4), by striking the period and inserting a semicolon; in paragraph (5), by striking the period and inserting ; and ; and by adding at the end the following: any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. .

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: A group health plan or a health insurance issuer offering group or individual health insurance coverage shall not impose any pre-authorization requirements with respect to coverage of the services described in section 2713(a)(6). . Section 8904 of title 5, United States Code, is amended by adding at the end the following: Any health benefits plan offered under this chapter 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 acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. .

Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— in subsection (a)(4)— by striking and

(D)and inserting

(D); and by inserting ; and

(E)HIV prevention services before the semicolon; and by adding at the end the following new subsection: For purposes of subsection (a)(4)(E), the term HIV prevention services means prescription drugs for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. . Title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) is amended— in section 1916, by inserting HIV prevention services described in section 1905(a)(4)(E), after section 1905(a)(4)(C), each place it appears; and in section 1916A(b)(3)(B), by adding at the end the following new clause: HIV prevention services described in section 1905(a)(4)(E). . Section 1937(b)(7) of the Social Security Act ( 42 U.S.C. 1396u–7(b)(7) ) is amended— in the paragraph header, by inserting after and HIV prevention services ; and supplies by inserting , and, for any individual described in section 1905(a)(4)(E), medical assistance for HIV prevention services in accordance with such section before the period. Section 2103(c) of the Social Security Act ( 42 U.S.C. 1397cc(c) ), as amended by section 5022 of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ), is amended by adding at the end the following new paragraph: The child health assistance provided to a targeted low-income child and the pregnancy-related assistance provided to a targeted low-income woman shall include coverage of HIV prevention services (as defined in section 1905(ff)). . Section 2103(e)(2) of the Social Security Act ( 42 U.S.C. 1397cc(e)(2) ) is amended by inserting , for HIV prevention services described in subsection (c)(10), after subsection (c)(1)(D) . Section 2103(a) of the Social Security Act ( 42 U.S.C. 1397cc(a) ), as amended by section 5022 of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ), is amended in the matter preceding paragraph

(1)by striking and

(8)and inserting (8), and

(10). Subject to subparagraph (A), the amendments made by subsection

(c)and this subsection shall take effect on January 1, 2021. In the case of a State plan approved under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by this section, 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 beginning 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 section. 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 legislature. Section 1861(ddd)(3) of the Social Security Act ( 42 U.S.C. 1395x(ddd)(3) ) is amended by adding at the end the following new subparagraph: Drugs or biologicals approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. . Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395l(a)(1) ) is amended— by striking and

(CC)and inserting

(CC); and by inserting before the semicolon at the end the following: , and

(DD)with respect to preventive services described in subparagraph

(D)of section 1861(ddd)(3), 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 treatment under this part, and

(ii)in the case of such services that are covered OPD services (as defined in subsection (t)(1)(B)), the amount determined under subsection

(t). Section 1833(b) of the Social Security Act ( 42 U.S.C. 1395l(b) ) is amended— in paragraph (9), by striking and at the end; and in paragraph (10), by striking the period at the end and inserting , and

(11)such deductible shall not apply with respect to preventive services described in subparagraph

(D)of section 1861(ddd)(3). . The amendments made by this paragraph shall apply to items and services furnished on or after January 1, 2021. Section 1860D–2(b) of the Social Security Act ( 42 U.S.C. 1395w–102(b) ) is amended— in paragraph (1)(A), by striking The coverage and inserting Subject to paragraph (8), the coverage ; in paragraph (2)(A), by striking and

(D)and inserting and

(D)and paragraph

(8); in paragraph (3)(A), by striking and

(4)and inserting (4), and

(8); in paragraph (4)(A)(i), by striking The coverage and inserting Subject to paragraph (8), the coverage ; and by adding at the end the following new paragraph: For plan year 2021 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 acquisition. For purposes of subparagraph (A), the elimination of cost-sharing shall include the following: The waiver of the deductible under paragraph (1). There waiver of coinsurance under paragraph (2). The initial coverage limit under paragraph

(3)shall not apply. The waiver of cost sharing under paragraph (4). . Section 1860D–14(a) of the Social Security Act ( 42 U.S.C. 1395w–114(a) ) is amended— in paragraph (1), in the matter preceding subparagraph (A), by striking In the case and inserting Subject to section 1860D–2(b)(8), in the case ; and in paragraph (2), in the matter preceding subparagraph (A), by striking In the case and inserting Subject to section 1860D–2(b)(8), in the case . Section 1722A(a) of title 38, United States Code, is amended by adding at the end the following new paragraph: Paragraph

(1)does not apply to a medication for the prevention of HIV acquisition. . Section 1710 of such title is amended— in subsection (f)— by redesignating paragraph

(5)as paragraph (6); and by inserting after paragraph

(4)the following new paragraph (5): A veteran shall not be liable to the United States under this subsection for any amounts for laboratory and other diagnostic procedures associated with the use of any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, or for laboratory or other diagnostic procedures associated with the use of such drugs, or clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. ; and in subsection (g)(3), by adding at the end the following new subparagraph: Any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. . Section 1701(9) of such title is amended— in subparagraph (K), by striking ; and and inserting a semicolon; by redesignating subparagraph

(L)as subparagraph (M); and by inserting after subparagraph

(K)the following new subparagraph (L): any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation; and . Chapter 55 of title 10, United States Code, is amended by inserting after section 1079c the following new section: The Secretary of Defense shall ensure coverage under the TRICARE program of HIV prevention treatment described in subsection

(b)for any beneficiary under section 1074(a) of this title. HIV prevention treatment described in this subsection includes any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. Notwithstanding section 1075, 1075a, or 1074g(a)(6) of this title or any other provision of law, there is no cost-sharing requirement for HIV prevention treatment covered under this section. . The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1079c the following new item: 1079d. Coverage of HIV prevention treatment. . The Indian Health Care Improvement Act is amended by inserting after section 223 ( 25 U.S.C. 1621v ) the following: The Secretary, acting through the Service, Indian tribes, and tribal organizations, shall provide funding for any prescription drug approved by the Food and Drug Administration for the prevention of HIV acquisition, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation. There are authorized to be appropriated to carry out this section such sums as may be necessary. . The amendments made by subsections (a), (b), (e), (f), (g), and

(h)shall take effect with respect to plan years beginning on or after January 1, 2021.

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