Bill Summary
The PrEP Access and Coverage Act aims to increase access to pre-exposure prophylaxis (PrEP) for the prevention of HIV transmission by amending existing legislation to include coverage for PrEP and related services without cost-sharing. It also establishes a grant program for states and tribes to support PrEP programs and allows for a private right of action for individuals who have been aggrieved by a violation of the act.
Possible Impacts
1. The PrEP Access and Coverage Act will ensure that individuals who are at high risk for HIV, such as members of the LGBTQ+ community and people of color, have increased access to PrEP and related services without facing barriers like preauthorization requirements or cost-sharing.
2. Under the new legislation, federal employees, Medicaid and CHIP recipients, Medicare beneficiaries, veterans, and active-duty military personnel will all have coverage for prescription drugs, diagnostic procedures, and clinical follow-up related to HIV prevention without having to pay any out-of-pocket costs.
3. The Act also establishes a grant program for states, territories, and Indian tribes to support the establishment of PrEP programs, providing funding for prescription drugs, diagnostic procedures, and outreach and education activities aimed at at-risk populations. Additionally, individuals who have been impacted by a violation of the Act have the right to seek relief through civil action, with the defendant covering the costs and attorney fees for the plaintiff.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1926 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
1st Session
S. 1926
To increase access to pre-exposure prophylaxis to reduce the
transmission of HIV.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 20, 2019
Ms. Harris introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To increase access to pre-exposure prophylaxis to reduce the
transmission of HIV.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``PrEP Access and Coverage Act''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) The Centers for Disease Control and Prevention
estimates that approximately 1,100,000 people in the United
States are living with HIV.
(2) In 2017, there were 38,281 new diagnoses of HIV in the
United States.
(3) HIV disproportionately impacts gay and bisexual men,
transgender women, and, in particular, people of color. For
example, in 2017 approximately 66 percent of new HIV diagnoses
were among gay and bisexual men, 43 percent of new HIV
diagnoses were among Black people, and 26 percent of new HIV
diagnoses were among Latinx people. Recent studies suggest that
transgender women are up to 49 times more likely to be
diagnosed with HIV than the general population. Members of
communities at the intersections of these groups are most
heavily impacted.
(4) Pre-exposure prophylaxis (referred to in this section
as ``PrEP'') is a daily antiretroviral medication that helps
prevent individuals from acquiring HIV. Daily PrEP use reduces
the risk of getting HIV from sex by over 90 percent. It reduces
the risk of getting HIV from injection drug use by over 70
percent.
(5) Many individuals at risk of exposure to HIV do not use
PrEP. Of the approximately 1,100,000 people in the United
States who could benefit from PrEP, only 7 percent, or 78,360
individuals, filled prescriptions for the drug in 2016.
(6) PrEP usage is inconsistent across racial and gender
lines. In 2016, PrEP users were 68.7 percent White, 11.2
percent Black, and 13.1 percent Latinx. However, individuals
eligible for PrEP were 26.3 percent White, 43.7 percent Black,
and 24.7 percent Latinx. Additionally, only 2.1 percent of
women eligible for PrEP received a prescription in 2016.
(7) There is currently only one version of PrEP approved by
the Food and Drug Administration, marketed under the brand name
of Truvada, which, in 2018, had a list price of over $20,000 a
year in the United States. A less expensive, generic version of
PrEP is expected to be available in September 2020, and other
types of HIV prevention treatments, including oral pills,
vaginal rings, and long-acting injectables, are currently in
the research pipeline.
(8) Section 2713 of the Public Health Service Act (42
U.S.C. 300gg-13) requires most private health insurance plans
to cover preventive services without cost-sharing, including
such services with a rating of ``A'' or ``B'' under
recommendations of the United States Preventive Services Task
Force. On June 11, 2019, the United States Preventive Services
Task Force issued a final recommendation giving an ``A'' grade
for PrEP for individuals at high risk of HIV; non-grandfathered
private health insurance plans will have to cover PrEP for such
individuals without cost-sharing by 2021.
(9) Despite such recommendation of the United States
Preventive Services Task Force, access barriers to PrEP remain.
Ancillary services necessary to maintain the PrEP regime,
including subsequent provider visits, clinical testing, and
other services, can remain a cost-burden on patients.
Additionally, the new recommendations are not linked to
coverage requirements for individuals with other types of
insurance, such as Medicare or Medicaid.
(10) Expanding access to cost-free PrEP and ancillary
services for all individuals, including individuals who do not
have health insurance, is a critical step towards eliminating
HIV transmission.
SEC. 3. COVERAGE OF HIV TESTING AND PREVENTION SERVICES.
(a) Private Insurance.--
(1) In general.--Section 2713(a) of the Public Health
Service Act (42 U.S.C. 300gg-13(a)) is amended--
(A) in paragraph (2), by striking ``; and'' and
inserting a semicolon;
(B) in paragraph (3), by striking the period and
inserting a semicolon;
(C) in paragraph (4), by striking the period and
inserting a semicolon;
(D) in paragraph (5), by striking the period and
inserting ``; and''; and
(E) by adding at the end the following:
``(6) any prescription drug approved by the Food and Drug
Administration for the prevention of HIV acquisition,
laboratory and other diagnostic procedures associated with the
use of such drugs, and clinical follow up and monitoring,
including any related services recommended in current United
States Public Health Service clinical practice guidelines,
without limitation.''.
(2) Prohibition on preauthorization requirements.--Subpart
II of part A of title XXVII of the Public Health Service Act
(42 U.S.C. 300gg-11 et seq.) is amended by adding at the end
the following:
``SEC. 2729. PROHIBITION ON PREAUTHORIZATION REQUIREMENTS WITH RESPECT
TO CERTAIN SERVICES.
``A group health plan or a health insurance issuer offering group
or individual health insurance coverage shall not impose any pre-
authorization requirements with respect to coverage of the services
described in section 2713(a)(6).''.
(b) Coverage Under Federal Employees Health Benefits Program.--
Section 8904 of title 5, United States Code, is amended by adding at
the end the following:
``(c) Any health benefits plan offered under this chapter shall
include benefits for, and may not impose any cost sharing requirements
for, any prescription drug approved by the Food and Drug Administration
for the prevention of HIV acquisition, laboratory and other diagnostic
procedures associated with the use of such drugs, and clinical follow
up and monitoring, including any related services recommended in
current United States Public Health Service clinical practice
guidelines, without limitation.''.
(c) Medicaid.--
(1) In general.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(A) in subsection (a)(4)--
(i) by striking ``and (D)'' and inserting
``(D)''; and
(ii) by inserting ``; and (E) HIV
prevention services'' before the semicolon; and
(B) by adding at the end the following new
subsection:
``(ff) HIV Prevention Services.--For purposes of subsection
(a)(4)(E), the term `HIV prevention services' means prescription drugs
for the prevention of HIV acquisition, laboratory and other diagnostic
procedures associated with the use of such drugs, and clinical follow
up and monitoring, including any related services recommended in
current United States Public Health Service clinical practice
guidelines, without limitation.''.
(2) No cost sharing.--Title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.) is amended--
(A) in section 1916, by inserting ``HIV prevention
services described in section 1905(a)(4)(E),'' after
``section 1905(a)(4)(C),'' each place it appears; and
(B) in section 1916A(b)(3)(B), by adding at the end
the following new clause:
``(xi) HIV prevention services described in
section 1905(a)(4)(E).''.
(3) Inclusion in benchmark coverage.--Section 1937(b)(7) of
the Social Security Act (42 U.S.C. 1396u-7(b)(7)) is amended--
(A) in the paragraph header, by inserting ``and hiv
prevention services'' after ``supplies''; and
(B) by inserting ``, and, for any individual
described in section 1905(a)(4)(E), medical assistance
for HIV prevention services in accordance with such
section'' before the period.
(d) CHIP.--
(1) In general.--Section 2103(c) of the Social Security Act
(42 U.S.C. 1397cc(c)), as amended by section 5022 of the
SUPPORT for Patients and Communities Act (Public Law 115-271),
is amended by adding at the end the following new paragraph:
``(10) HIV prevention services.--The child health
assistance provided to a targeted low-income child and the
pregnancy-related assistance provided to a targeted low-income
woman shall include coverage of HIV prevention services (as
defined in section 1905(ff)).''.
(2) No cost sharing.--Section 2103(e)(2) of the Social
Security Act (42 U.S.C. 1397cc(e)(2)) is amended by inserting
``, for HIV prevention services described in subsection
(c)(10),'' after ``subsection (c)(1)(D)''.
(3) Conforming amendment.--Section 2103(a) of the Social
Security Act (42 U.S.C. 1397cc(a)), as amended by section 5022
of the SUPPORT for Patients and Communities Act (Public Law
115-271), is amended in the matter preceding paragraph (1) by
striking ``and (8)'' and inserting ``(8), and (10)''.
(4) Effective date.--
(A) In general.--Subject to subparagraph (A), the
amendments made by subsection (c) and this subsection
shall take effect on January 1, 2021.
(B) Delay permitted if state legislation
required.--In the case of a State plan approved under
title XIX of the Social Security Act which the
Secretary of Health and Human Services determines
requires State legislation (other than legislation
appropriating funds) in order for the plan to meet the
additional requirements imposed by this section, the
State plan shall not be regarded as failing to comply
with the requirements of such title solely on the basis
of the failure of the plan to meet such additional
requirements before the 1st day of the 1st calendar
quarter beginning after the close of the 1st regular
session of the State legislature that ends after the 1-
year period beginning with the date of the enactment of
this section. For purposes of the preceding sentence,
in the case of a State that has a 2-year legislative
session, each year of the session is deemed to be a
separate regular session of the State legislature.
(e) Waiver of Cost-Sharing Under Medicare.--
(1) Part b.--
(A) Inclusion as a preventive service.--Section
1861(ddd)(3) of the Social Security Act (42 U.S.C.
1395x(ddd)(3)) is amended by adding at the end the
following new subparagraph:
``(D) Drugs or biologicals approved by the Food and
Drug Administration for the prevention of HIV
acquisition, laboratory and other diagnostic procedures
associated with the use of such drugs, and clinical
follow up and monitoring, including any related
services recommended in current United States Public
Health Service clinical practice guidelines, without
limitation.''.
(B) Elimination of coinsurance.--Section 1833(a)(1)
of the Social Security Act (42 U.S.C. 1395l(a)(1)) is
amended--
(i) by striking ``and (CC)'' and inserting
``(CC)''; and
(ii) by inserting before the semicolon at
the end the following: ``, and (DD) with
respect to preventive services described in
subparagraph (D) of section 1861(ddd)(3), the
amount paid shall be 100 percent of (i) except
as provided in clause (ii), the lesser of the
actual charge for the service or the amount
determined under the fee schedule that applies
to such treatment under this part, and (ii) in
the case of such services that are covered OPD
services (as defined in subsection (t)(1)(B)),
the amount determined under subsection (t)''.
(C) Exemption from part b deductible.--Section
1833(b) of the Social Security Act (42 U.S.C. 1395l(b))
is amended--
(i) in paragraph (9), by striking ``and''
at the end; and
(ii) in paragraph (10), by striking the
period at the end and inserting ``, and (11)
such deductible shall not apply with respect to
preventive services described in subparagraph
(D) of section 1861(ddd)(3).''.
(D) Effective date.--The amendments made by this
paragraph shall apply to items and services furnished
on or after January 1, 2021.
(2) Part d.--
(A) In general.--Section 1860D-2(b) of the Social
Security Act (42 U.S.C. 1395w-102(b)) is amended--
(i) in paragraph (1)(A), by striking ``The
coverage'' and inserting ``Subject to paragraph
(8), the coverage'';
(ii) in paragraph (2)(A), by striking ``and
(D)'' and inserting ``and (D) and paragraph
(8)'';
(iii) in paragraph (3)(A), by striking
``and (4)'' and inserting ``(4), and (8)'';
(iv) in paragraph (4)(A)(i), by striking
``The coverage'' and inserting ``Subject to
paragraph (8), the coverage''; and
(v) by adding at the end the following new
paragraph:
``(8) Limitations on cost-sharing for drugs for the
prevention of hiv acquisition.--
``(A) In general.--For plan year 2021 and each
subsequent plan year, there shall be no cost-sharing
under this part (including under section 1814D-14) for
covered part D drugs that are for the prevention of HIV
acquisition.
``(B) Cost-sharing.--For purposes of subparagraph
(A), the elimination of cost-sharing shall include the
following:
``(i) No application of deductible.--The
waiver of the deductible under paragraph (1).
``(ii) No application of coinsurance.--The
waiver of coinsurance under paragraph (2).
``(iii) No application of initial coverage
limit.--The initial coverage limit under
paragraph (3) shall not apply.
``(iv) No cost sharing above annual out-of-
pocket threshold.--The waiver of cost sharing
under paragraph (4).''.
(B) Conforming amendments to cost sharing for low-
income individuals.--Section 1860D-14(a) of the Social
Security Act (42 U.S.C. 1395w-114(a)) is amended--
(i) in paragraph (1), in the matter
preceding subparagraph (A), by striking ``In
the case'' and inserting ``Subject to section
1860D-2(b)(8), in the case''; and
(ii) in paragraph (2), in the matter
preceding subparagraph (A), by striking ``In
the case'' and inserting ``Subject to section
1860D-2(b)(8), in the case''.
(f) Coverage of HIV Prevention Treatment by Department of Veterans
Affairs.--
(1) Elimination of medication copayments.--Section 1722A(a)
of title 38, United States Code, is amended by adding at the
end the following new paragraph:
``(5) Paragraph (1) does not apply to a medication for the
prevention of HIV acquisition.''.
(2) Elimination of hospital care and medical services
copayments.--Section 1710 of such title is amended--
(A) in subsection (f)--
(i) by redesignating paragraph (5) as
paragraph (6); and
(ii) by inserting after paragraph (4) the
following new paragraph (5):
``(5) A veteran shall not be liable to the United States under this
subsection for any amounts for laboratory and other diagnostic
procedures associated with the use of any prescription drug approved by
the Food and Drug Administration for the prevention of HIV acquisition,
or for laboratory or other diagnostic procedures associated with the
use of such drugs, or clinical follow up and monitoring, including any
related services recommended in current United States Public Health
Service clinical practice guidelines, without limitation.''; and
(B) in subsection (g)(3), by adding at the end the
following new subparagraph:
``(C) Any prescription drug approved by the Food and Drug
Administration for the prevention of HIV acquisition,
laboratory and other diagnostic procedures associated with the
use of such drugs, and clinical follow up and monitoring,
including any related services recommended in current United
States Public Health Service clinical practice guidelines,
without limitation.''.
(3) Inclusion as preventive health service.--Section
1701(9) of such title is amended--
(A) in subparagraph (K), by striking ``; and'' and
inserting a semicolon;
(B) by redesignating subparagraph (L) as
subparagraph (M); and
(C) by inserting after subparagraph (K) the
following new subparagraph (L):
``(L) any prescription drug approved by the Food
and Drug Administration for the prevention of HIV
acquisition, laboratory and other diagnostic procedures
associated with the use of such drugs, and clinical
follow up and monitoring, including any related
services recommended in current United States Public
Health Service clinical practice guidelines, without
limitation; and''.
(g) Coverage of HIV Prevention Treatment by Department of
Defense.--
(1) In general.--Chapter 55 of title 10, United States
Code, is amended by inserting after section 1079c the following
new section:
``Sec. 1079d. Coverage of HIV prevention treatment
``(a) In General.--The Secretary of Defense shall ensure coverage
under the TRICARE program of HIV prevention treatment described in
subsection (b) for any beneficiary under section 1074(a) of this title.
``(b) HIV Prevention Treatment Described.--HIV prevention treatment
described in this subsection includes any prescription drug approved by
the Food and Drug Administration for the prevention of HIV acquisition,
laboratory and other diagnostic procedures associated with the use of
such drugs, and clinical follow up and monitoring, including any
related services recommended in current United States Public Health
Service clinical practice guidelines, without limitation.
``(c) No Cost-Sharing.--Notwithstanding section 1075, 1075a, or
1074g(a)(6) of this title or any other provision of law, there is no
cost-sharing requirement for HIV prevention treatment covered under
this section.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 1079c the following new item:
``1079d. Coverage of HIV prevention treatment.''.
(h) Indian Health Service Testing, Monitoring, and Prescription
Drugs for the Prevention of HIV Acquisition.--The Indian Health Care
Improvement Act is amended by inserting after section 223 (25 U.S.C.
1621v) the following:
``SEC. 224. TESTING, MONITORING, AND PRESCRIPTION DRUGS FOR THE
PREVENTION OF HIV ACQUISITION.
``(a) In General.--The Secretary, acting through the Service,
Indian tribes, and tribal organizations, shall provide funding for any
prescription drug approved by the Food and Drug Administration for the
prevention of HIV acquisition, laboratory and other diagnostic
procedures associated with the use of such drugs, and clinical follow
up and monitoring, including any related services recommended in
current United States Public Health Service clinical practice
guidelines, without limitation.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be
necessary.''.
(i) Effective Date.--The amendments made by subsections (a), (b),
(e), (f), (g), and (h) shall take effect with respect to plan years
beginning on or after January 1, 2021.
SEC. 4. PROHIBITION ON DENIAL OF COVERAGE OR INCREASE IN PREMIUMS OF
LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE FOR
INDIVIDUALS TAKING MEDICATION FOR THE PREVENTION OF HIV
ACQUISITION.
(a) Prohibition.--Notwithstanding any other provision of law, it
shall be unlawful to--
(1) decline or limit coverage of a person under any life
insurance policy, disability insurance policy, or long-term
care insurance policy, on account of the individual taking
medication for the purpose of preventing the acquisition of
HIV;
(2) preclude an individual from taking medication for the
purpose of preventing the acquisition of HIV as a condition of
receiving a life insurance policy, disability insurance policy,
or long-term care insurance policy;
(3) consider whether an individual is taking medication for
the purpose of preventing the acquisition of HIV in determining
the premium rate for coverage of such individual under a life
insurance policy, disability insurance policy, or long-term
care insurance policy; or
(4) otherwise discriminate in the offering, issuance,
cancellation, amount of such coverage, price, or any other
condition of a life insurance policy, disability insurance
policy, or long-term care insurance policy for an individual,
based solely and without any additional actuarial risks upon
whether the individual is taking medication for the purpose of
preventing the acquisition of HIV.
(b) Enforcement.--A State insurance regulator may take such actions
to enforce subsection (a) as are specifically authorized under the laws
of such State.
(c) Definitions.--In this section:
(1) Disability insurance policy.--The term ``disability
insurance policy'' means a contract under which an entity
promises to pay a person a sum of money in the event that an
illness or injury resulting in a disability prevents such
person from working.
(2) Life insurance policy.--The term ``life insurance
policy'' means a contract under which an entity promises to pay
a designated beneficiary a sum of money upon the death of the
insured.
(3) Long-term care insurance policy.--The term ``long-term
care insurance policy'' means a contract for which the only
insurance protection provided under the contract is coverage of
qualified long-term care services (as defined in section
7702B(c) of the Internal Revenue Code of 1986).
SEC. 5. PUBLIC EDUCATION CAMPAIGN.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399V-7. PRE-EXPOSURE PROPHYLAXIS PUBLIC EDUCATION CAMPAIGN.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall establish a
public health campaign for the purpose of educating the public on
medication for the prevention of HIV acquisition.
``(b) Requirements.--In carrying out this section, the Secretary
shall ensure cultural competency and efficacy within high-need
communities in which PrEP is underutilized by developing the campaign
in collaboration with organizations that are indigenous to communities
that are overrepresented in the domestic HIV epidemic, including
communities of color and the lesbian, gay, bisexual, transgender, and
queer community. The Secretary shall ensure that the campaign is
designed to increase awareness of the safety and effectiveness of PrEP,
the recommended clinical practices for providing PrEP-related clinical
care, and the local availability of PrEP providers, and to counter
stigma associated with the use of PrEP.
``(c) Evaluation of Program.--The Secretary shall develop measures
to evaluate the effectiveness of activities conducted under this
section that are aimed at reducing disparities in access to PrEP and
supporting the local community. Such measures shall evaluate community
outreach activities, language services, workforce cultural competence,
and other areas as determined by the Secretary.
``(d) PrEP.--In this section, the term `PrEP' means any drug
approved by the Food and Drug Administration for the purpose of pre-
exposure prophylaxis with respect to HIV.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary for each of fiscal years
2021 through 2026.''.
SEC. 6. PATIENT CONFIDENTIALITY.
The Secretary of Health and Human Services shall amend the
regulations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 note), as
necessary, to ensure that individuals are able to access the benefits
described in section 2713(a)(6) under a family plan without any other
individual enrolled in such family plan, including a primary subscriber
of or policyholder, being informed of such use of such benefits.
SEC. 7. PRE-EXPOSURE PROPHYLAXIS FUNDING.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Secretary of Health and Human Services (in this Act
referred to as the ``Secretary'') shall establish a program that
provides grants to States, territories, and Indian Tribes for the
establishment and support of pre-exposure prophylaxis (referred to in
this section as ``PrEP'') programs, or establishes a program for
providing Federal funding directly to eligible entities within a State,
territory, or Indian Tribal territory, in the case of a State,
territory, or Indian Tribe that does not apply for such a grant.
(b) Grant Program.--
(1) Applications.--To be eligible to receive a grant under
subsection (a), a State, territory, or Indian Tribe shall--
(A) submit an application to the Secretary at such
time, in such manner, and containing such information
as the Secretary may require, including a description
of how any funds awarded will be used and a plan
describing how any funds awarded will be used to
increase access to PrEP for uninsured individuals and
reduce disparities in access to PrEP; and
(B) appoint a PrEP grant administrator to manage
the program.
(2) Use of funds.--Any State, Territory of the United
States, or Indian Tribe that is awarded funds under subsection
(a) shall use such funds for eligible PrEP expenses.
(c) Federal Program.--
(1) In general.--In the case of a State, territory, or
Indian Tribe that does not submit an application under
subsection (b), the Secretary shall provide funding to any of
the following, within the applicable State, territory, or
Indian Tribal territory:
(A) Federally qualified health centers (as defined
in section 1861(aa)(4) of the Social Security Act (42
U.S.C. 1395x(aa)(4)).
(B) Family planning grantees (other than States)
funded under section 1001 of the Public Health Service
Act (42 U.S.C. 300).
(C) Rural health clinics (as defined in section
1861(aa)(2) of the Social Security Act (42 U.S.C.
1395x(aa)(2)).
(D) Health facilities operated by or pursuant to a
contract with the Indian Health Service.
(E) Community-based organizations, clinics,
hospitals, and other health facilities that provide
services to individuals at risk for or living with HIV.
(F) Nonprofit private entities providing
comprehensive primary care to populations at risk of
HIV, including faith-based and community-based
organizations.
(2) Use of funds.--Any entity receiving funding under
paragraph (1) shall use such funds for eligible PrEP expenses.
(d) Eligible PrEP Expenses.--
(1) In general.--The Secretary shall publish a list of
expenses that qualify as eligible PrEP expenses for purposes of
this section.
(2) Inclusions.--Such list shall include--
(A) any prescription drug approved by the Food and
Drug Administration for the prevention of HIV
acquisition, laboratory and other diagnostic procedures
associated with the use of such drugs, and clinical
follow up and monitoring, including any related
services recommended in current United States Public
Health Service clinical practice guidelines, without
limitation;
(B) outreach and public education activities
directed toward populations overrepresented in the
domestic HIV epidemic that increase awareness about the
existence of PrEP, provide education about access to
and health care coverage of PrEP, and counter stigma
associated with the use of PrEP; and
(C) outreach activities directed toward physicians
and other providers that provide education about PrEP.
(e) Report to Congress.--The Secretary shall, in each of the first
5 years beginning one year after the date of the enactment of this Act,
submit to Congress, and make public on the internet website of
Department of Health and Human Services, a report on the impact of any
grants provided to States, territories, and Indian Tribes for the
establishment and support of pre-exposure prophylaxis programs under
this section.
(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $60,000,000 for each of the
first 5 fiscal years beginning after the date of the enactment of this
section.
SEC. 8. CLARIFICATION.
This Act, including the amendments made by this Act, shall apply
notwithstanding any other provision of law, including Public Law 103-
141.
SEC. 9. PRIVATE RIGHT OF ACTION.
Any person aggrieved by a violation of this Act, including the
amendments made by this Act, may commence a civil action in an
appropriate United States District Court or other court of competent
jurisdiction to obtain relief as allowed by law as either an individual
or member of a class. If the plaintiff is the prevailing party in such
an action, the court shall order the defendant to pay the costs and
reasonable attorney fees of the plaintiff.
<all>