H.R. 7385 — PrEP Assistance Program Act

This section establishes a grant program, to be implemented by the Secretary of Health and Human Services (HHS), acting through the Director of the Centers for Disease Control and Prevention (CDC) in collaboration with the Administrator of the Health Resources and Services Administration, under which eligible entities may receive grants of up to $10 million to establish or support pre-exposure prophylaxis (PrEP) programs that provide PrEP medications (i.e., FDA-approved drugs to prevent HIV acquisition) and related services at no cost to recipients. Eligible entities include states, local governments, Indian Tribal governments (as defined in 25 U.S.C. 5130), Federally qualified health centers, rural health clinics, community-based organizations, hospital-based clinics, and university-based clinics; grant preferences are given to entities serving communities with high HIV incidence rates (e.g., rural, uninsured, or high-risk demographic groups) or using innovative delivery models (e.g., vending machines, pop-up clinics, peer-led interventions). Grant funds may cover specified expenses, including clinic and lab fees, office and telehealth visits, PrEP medications, HIV-related testing, sexually transmitted disease testing per CDC guidelines, adherence counseling, physician education and outreach, peer navigation, case management, transportation, and mental health services. Non-Indian Tribal government grantees must provide matching funds of at least 10% of the grant amount, which HHS may waive for Federally qualified health centers, rural health clinics, community-based organizations, hospital-based clinics, or university-based clinics. HHS must submit annual reports to Congress for five years (beginning one year after enactment), including disaggregated data by race, gender identity, age, and geography on grant impacts and reductions in PrEP service disparities and prevalence. The section authorizes $400 million annually for FY2027 through FY2031.

This section requires the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, to establish a reimbursement program—not later than one year after enactment—under which program-registered health care providers submit claims for furnishing specified HIV prevention items and services (i.e., FDA-approved drugs for HIV prevention, including pre-exposure prophylaxis (PrEP), administrative fees, and CDC-recommended associated laboratory and diagnostic procedures) to uninsured individuals, with the Secretary paying providers (subject to appropriations) and issuing a "PrEP Pass" card or technology enabling no-cost access for such individuals. The Secretary sets payment amounts (reviewed at least every two years), equal to Medicare Part B amounts under section 1834A of the Social Security Act for covered laboratory tests. Program-registered providers are licensed providers agreeing not to bill uninsured individuals; uninsured individuals lack coverage under federal health care programs, group or individual market plans, or the Federal Employees Health Benefits program.