PrEP Access and Coverage Act of 2026

(a) In general. The Secretary of Health and Human Services, in consultation with the Centers for Disease Control and Prevention, shall—

(1) issue guidance regarding the implementation of the coverage requirements established under this Act, including the amendments made by this Act, including with respect to implementation of such coverage requirements;

(2) develop and disseminate educational materials, including billing and coding documents based on stakeholder consensus-driven recommendations, as appropriate;

(3) provide technical assistance to State insurance commissioners;

(4) provide technical assistance to eligible entities regarding responding to consumer complaints and assisting in resolving such complaints; and

(5) work with other Federal agencies to assist in enforcement and compliance.

(b) Compliance

(1) In general. The Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Director of the Centers for Disease Control and Prevention, shall monitor compliance by group health plans and health insurance issuers with coverage requirements established under sections 2799A–11 of the Public Health Service Act, 726 of the Employee Retirement Income Security Act of 1974, and 9826 of the Internal Revenue Code of 1986 (as added by section 3(a)) and shall take appropriate enforcement actions under such Acts and such Code.

(2) Insurer submissions to the Secretary. Beginning not later than 1 year after the date of enactment of this Act, each group health plan and health insurance issuer offering group or individual health insurance coverage shall submit to the Secretary of Health and Human Services, at such time as such secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall require, but not less frequently than annually for the 10-year period beginning on such date of enactment, data demonstrating compliance with the coverage requirements described in paragraph (1), including aggregate data on the number of claims received by such plans and issuers for HIV prevention services and the cost-sharing for enrollees with respect to such claims.

(3) Reports to Congress. Not later than 2 years after the date of enactment of this Act and every 2 years thereafter for the 10-year period beginning on such date of enactment, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury (collectively referred to in this section as the Secretaries) shall jointly submit to Congress and make publicly available a report to assess the prevalence of noncompliance with the coverage requirements described in paragraph (1). Each such report shall include—

(A) aggregate information about group health plans and health insurance issuers that the Secretaries determine to be out of compliance with such requirements; and

(B) steps the Secretaries have taken to address incidences of such noncompliance.

(4) Definitions. In this subsection, the terms group health plan, health insurance coverage, and health insurance issuer have the meanings given such terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91).