PrEP Insurance Regulations

Residents of the nation’s capital may soon be able to more easily access HIV prevention medications, including long-acting injectable formulations. The 13-member D.C. Council, which enacts laws as the district’s legislative authority, passed B26-0159, also known as the D.C. PrEP Act. The bill prohibits insurance carriers from using HIV prevention medications to set disparate premium rates, imposing prior authorizations, or requiring cost-sharing or copays for any HIV prevention drug. Councilmembers already passed the legislation out of two committees last year; this year, the legislation was fast-tracked for a full council vote on both Feb 3 and March 3, where it passed both times unanimously and now goes to the mayor.

HIV Prevention at the Pharmacy

D.C.’s PrEP Act is not the only HIV-prevention bill that advanced last year and remains under consideration for this legislative session. Georgia state Senator Chuck Hufstetler (R – Rome) introduced SB195 last year, which would authorize pharmacists to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention. While the bill passed the State Senate unanimously, it failed to secure a House vote before session adjourned in 2025. In Georgia, like many other states, bills introduced in certain legislative sessions can carry over into the next. As a result, the bill was routed back to the House this year and passed on February 12, 155-7.

State lawmakers across the U.S. have varied in how they regulate PrEP access at the pharmacy, often weighing implementation consideration and a complex web of state pharmacy laws to build consensus on a framework. In Georgia, pharmacists would be able to prescribe oral PrEP for up to 30 days or administer long-acting injectable PrEP, but only the latter if they enter a protocol agreement with a licensed physician.

Meanwhile, Maryland policymakers are also debating pharmacists’ authority for HIV prevention. Although the state already allows pharmacists to prescribe post-exposure prophylaxis (PEP) through a standing order, HB1114, first introduced by Delegate Ashanti Martinez (D – Prince George’s County), would expand the regulation by allowing pharmacists to also prescribe and dispense PrEP. Additionally, the bill would reinforce no-cost sharing provisions for patients during PrEP visits so that ancillary services like STI testing are not subject to any copays or deductibles.

Vaccination Authority

In New York, lawmakers may decide whether nursing students should play a more direct role in vaccine access. Senator James Skoufis (D – Cornwall) introduced a bill that would authorize licensed providers to prescribe standing orders allowing nursing students to administer vaccines from an approved list to patients. The students would then report the vaccination through the state’s immunization documentation system to ensure it is properly recorded. The list of vaccines eligible for the process, should the bill become law, include HPV, hepatitis A, and hepatitis B.