CMS is proposing new coverage guidelines for HIV prevention drugs in Medicare, requiring the program to cover the drugs without cost sharing for beneficiaries.
In a July 12 memo, CMS issued a proposed decision that would require Medicare to cover pre-exposure prophylaxis, or PrEP, treatments in both oral and injectable forms with no cost to beneficiaries.
Medicare currently covers oral PrEP medications through Part D, where members are responsible for copays for the drug, according to the HIV+Hepatitis Policy Institute.
"Today's announcement marks a huge step in ensuring Medicare beneficiaries who want to protect themselves against HIV by using either daily oral or long-acting PrEP can do so without cost-sharing. As people are living longer and remain sexually active, it is important that anyone who has a reason to be on PrEP can access it," Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in a statement shared with Becker's.
The proposed decision is open for public comment through Aug. 11.