On July 17, 2024, 63 organizations dedicated to ending HIV, requested the Centers for Medicaid and Medicare Services (CMS) issue updated guidance to ensure coverage requirements are consistent with the latest U.S. Preventative Services Taskforce (USPSTF) recommendations for HIV Pre-Exposure Prophylaxis (PrEP), which now includes coverage for the first long-acting PrEP treatment.
The letter urges CMS to update its guidance to cover all FDA-approved PrEP medications without cost-sharing, as required by Section 2713 of the Affordable Care Act, to prevent delays and financial barriers to access. It emphasizes that comprehensive PrEP care should include necessary clinical visits and laboratory tests, which must also be covered without cost-sharing. Additionally, CMS is urged to eliminate utilization management barriers like prior authorization and step therapy, which hinder access to PrEP. By ensuring all individuals at risk of HIV can access these medications and services without financial obstacles, CMS can address disparities and advance efforts to end the HIV epidemic. Read the letter.
Last Updated on August 9, 2024 by Aimed Alliance
