The bill amends the General Laws to require coverage for HIV prevention medications, specifically pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), by health insurance contracts, policies, or plans starting January 1, 2024. It mandates that insurers provide at least one PrEP drug for each method of administration and at least one CDC preferred PEP regimen without prior authorization or step therapy. The bill also eliminates copayments and deductibles for these prescriptions and removes the requirement for the drugs to be dispensed or administered by an in-network pharmacy provider, unless the plan includes an out-of-network pharmacy benefit.

Furthermore, the bill repeals sections of the General Laws that allowed for expedited prior authorization, reflecting the new requirement that PrEP and PEP drugs be accessible without prior authorization. The deleted language that required prior authorizations to be conducted within seventy-two hours is removed, and a new section is inserted, effective January 1, 2024, although the content of this new section is not detailed in the summary. The act is scheduled to take effect on January 1, 2025.

Statutes affected:
2255  SUB A: 27-18-91, 27-18-92, 27-19-83, 27-19-84, 27-20-79, 27-20-80, 27-41-96, 27-41-97
2255: 27-18-91, 27-18-92, 27-19-83, 27-19-84, 27-20-79, 27-20-80, 27-41-96, 27-41-97