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Section 72

Section 72 PREP Coverage 2

Said chapter 118E is hereby further amended by inserting after section 10Z the following section:-
Section 10AA. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:
"Health care provider", as defined in section 1 of chapter 111.
"HIV", human immunodeficiency virus.
"HIV prevention drug", any pre-exposure prophylaxis drug approved for the prevention of HIV by the federal Food and Drug Administration, including any ancillary or support health service determined by the secretary of health and human services to be necessary to: (i) ensure that a drug is prescribed or administered to a person who is not infected with HIV and has no medical contraindications to the use of a drug; and (ii) monitor a person to ensure the safe and effective ongoing use of a drug through: (A) office visits; (B) laboratory testing; (C) testing for a sexually transmitted infection; (D) medication self-management and adherence counseling; or (E) any other health service specified as part of comprehensive HIV prevention drug services by the U.S. Department of Health and Human Services, the federal Centers for Disease Control and Prevention, the United States Preventive Services Task Force or an equivalent state-authorized body with responsibility to identify health services that are components of comprehensive HIV prevention drug services.
(b) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization, accountable care organization or primary care clinician plan shall provide coverage for an HIV prevention drug. There shall be no: (i) patient cost sharing; or (ii) prior authorization, step therapy or any other protocol that could restrict or delay the dispensing of any HIV prevention drug.
(c) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization, accountable care organization or primary care clinician plan shall not refuse, reject or deny a prescription for any covered HIV prevention drug on the basis of the type of health care provider issuing the prescription for an HIV prevention drug or the venue or practice setting of the health care provider issuing the prescription; provided, however, that the health care provider shall be licensed to prescribe medications.