PrEP Access Act

The PrEP Access Act expands Medicare Part B coverage to include pharmacist-provided HIV prevention services, such as pre-exposure prophylaxis (PrEP) counseling, medication administration, and related testing. It directly affects Medicare beneficiaries (primarily seniors) and pharmacists, allowing pharmacists to bill Medicare for these services under state law. Key provisions set payment at 80% of the lesser of actual charges or 85% of physician rates, and prohibit balance billing for these services. The policy change takes effect January 1, 2027, making PrEP more accessible through pharmacy settings.