PrEP Assistance Program Act

Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention (in this section referred to as the Secretary) and in collaboration with the Administrator of the Health Resources and Services Administration, shall establish a program that provides grants to eligible entities to establish and support PrEP programs.

To be eligible to receive a grant under subsection (a), an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a description of how any amounts awarded shall be used.

In making grants under this section, the Secretary shall give preference to an eligible entity that demonstrates a record of—

(1) serving communities with disproportionately high rate of incidence for human immunodeficiency virus (in this section referred to as HIV), including individuals located in rural communities, uninsured individuals, or individuals in demographic groups at high risk of contracting HIV; or

(2) implementing innovative models to provide items or services, including the use of vending machines, pop-up clinics, and peer-led interventions.

Any grant provided to an eligible entity under this section may not exceed $10,000,000.

Any eligible entity that is awarded an amount under subsection (a) shall use such amount for expenses associated with establishing a PrEP program or supporting an existing PrEP program.

The Secretary shall publish a list of eligible expenses associated with establishing a PrEP program or supporting an existing PrEP program. Such list shall include—

(A) clinic and laboratory fees;

(B) office visits, including telehealth visits;

(C) PrEP medication;

(D) blood and urine testing as required in association with the use of PrEP medication;

(E) sexually transmitted disease testing in accordance with guidelines issued by the Centers for Disease Control and Prevention;

(F) adherence services and counseling;

(G) outreach activities directed toward assisting health professionals to become eligible to prescribe pre-exposure prophylaxis medications in the State or Indian Tribal government where the program is operating;

(H) outreach activities directed toward physicians that provide education about PrEP;

(I) peer navigation;

(J) case management;

(K) transportation support;

(L) mental health services; and

(M) other similar items or services.

An individual that receives a service or item from a PrEP program established or supported using amounts under this section may not be required to provide payment for such service or item.

Except with respect to an Indian Tribal government, a grantee under this section shall contribute, to the PrEP program established or supported by the grant, an amount equal to not less than 10 percent of the amount of the grant.

The Secretary may waive the requirement under paragraph (1) for a Federally qualified health center, rural health clinic, community-based organization, hospital-based clinic, or university-based clinic if the Secretary determines such a waiver is necessary.

The Secretary shall, in each of the first 5 years beginning 1 year after the date of the enactment of this Act, submit to Congress, and make public on the internet website of the Department of Health and Human Services, a report on the impact of grants provided to eligible entities under this Act.

A report submitted under paragraph (1) shall—

(A) include disaggregated data by race, gender identity, age, and geographic location; and

(B) evaluate, with respect to the period covered by the report, any reduction in—

(i) the disparity of the prevalence of PrEP services provided within the demographics described in this paragraph; and

(ii) the prevalence of PrEP.

There are authorized to be appropriated to carry out this Act $400,000,000 for each of fiscal years 2027 through 2031.

In this Act:

The term community-based organization means a nonprofit or private organization that—

(A) represents a community or significant segments of a community;

(B) provides health care or health-related services to high-risk or high-need individuals in a community; and

(C) demonstrates effectiveness with respect to such health care or health-related services.

The term eligible entity means—

(A) a State;

(B) a local government;

(C) an Indian Tribal government;

(D) a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)));

(E) a rural health clinic (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)));

(F) a community-based organization;

(G) a hospital-based clinic; or

(H) a university-based clinic.

The term Indian Tribal government means the governing body of any Indian tribe (as defined in section 102 of the Federally Recognized Indian Tribe List Act of 1994 (25 U.S.C. 5130)).

The term PrEP program means a program designed to provide pre-exposure prophylaxis and pre-exposure prophylaxis-related services to individuals.

The term PrEP medication means any medication approved by the Federal Drug Administration and designed to prevent individuals at risk of contracting HIV from contracting HIV.

The term State means each State of the United States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

Not later than 1 year after the date of the enactment of this section, the Secretary of Health and Human Services shall establish a program under which—

(1) program-registered providers submit claims to the Secretary with respect to the furnishing of specified HIV prevention items and services to uninsured individuals;

(2) the Secretary, subject to the availability of appropriations, pays each such provider for such items and services in an amount established under subsection (b); and

(3) the Secretary provides for the development and distribution of a card (or other technology), to be referred to as a PrEP Pass, that may be used by an uninsured individual to assure access to specified HIV prevention items and services from program-registered providers at no cost to such individual.

Subject to paragraph (2), the Secretary shall establish a payment amount for each specified HIV prevention item or service under the program under subsection (a). The Secretary shall review such payment amount not less frequently than once every 2 years.

In the case of a specified HIV prevention item or service that is a clinical diagnostic laboratory test covered under part B of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the payment amount for such test under the program under subsection (a) shall be equal to the payment amount determined with respect to such test under section 1834A of such Act.

In this section:

The term specified HIV prevention items and services means—

(A) any drug approved by the Federal Drug Administration for the prevention of HIV, including any such drug approved for use as pre-exposure prophylaxis (commonly referred to as PrEP), and administrative fees for such drugs; and

(B) laboratory and other diagnostic procedures associated with the use of such drugs that are recommended in the most recent clinical practice guidelines of the Centers for Disease Control and Prevention.

The term program-registered provider means a health care provider that—

(A) is licensed or otherwise authorized to furnish a specified HIV prevention item or service in the State in which such provider furnishes such item or service under the program established under this section; and

(B) enters into an agreement with the Secretary under which the provider agrees not to hold an uninsured individual liable for the cost of specified HIV prevention items and services with respect to which a payment is made under subsection (a)(2).

The term Secretary means the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration.

The term uninsured individual means, with respect to an individual furnishing a specified HIV prevention item or service, an individual who is not enrolled in—

(A) a Federal health care program (as defined in section 1128B(f) of the Social Security Act (42 U.S.C. 1320a–7b(f)));

(B) a group health plan or health insurance coverage offered by a health insurance issuer in the group or individual market (as such terms are defined in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91)); or

(C) a health plan offered under chapter 89 of title 5, United States Code.