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SB 6127

Increasing access to human immunodeficiency virus postexposure prophylaxis drugs or therapies.

2023-2024 Regular Session Introduced by Noel Frame and 9 co-sponsors

Requires hospitals to dispense a 28-day take-home HIV PEP and bans cost-sharing or prior authorization for CDC-recommended regimens, speeding access after exposure.

Effective date 1/1/2025.
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Bill Summary · SB 6127

SB 6127 — Increasing access to HIV post‑exposure prophylaxis (PEP)

Status: Chapter 251, 2024 Laws (Governor signed 3/25/2024). Effective date: January 1, 2025.

Purpose

To improve timely access to human immunodeficiency virus (HIV) post‑exposure prophylaxis (PEP) — a time‑sensitive 28‑day medication regimen that must be started within 72 hours of a possible exposure — by requiring hospitals to dispense take‑home PEP and by removing common payer barriers (cost‑sharing and prior authorization).

Key provisions

  • Hospital policies

    • Hospitals must adopt policies, consistent with CDC PEP guidelines, to dispense or deliver to an eligible patient a 28‑day supply of HIV PEP drugs or therapies (with patient informed consent), unless medically contraindicated or inconsistent with CDC or accepted standards of care.
    • When available, hospitals must dispense or deliver generic PEP products.
    • The law preserves existing reimbursement processes for sexual assault victims (Crime Victims Compensation) and worker exposures (Industrial Insurance Act).

  • Emergency department/prepackaged medication rules

    • Hospitals may authorize practitioners to prescribe PEP as prepackaged emergency medication and permit practitioners or registered nurses to distribute PEP at discharge.
    • The prepackaged medication rules are modified to explicitly include antibiotics and PEP as circumstances that may justify exceeding the usual 48‑hour dispensing limit (and removes the prior 96‑hour cap in some amended language).

  • Insurance, Medicaid, and Health Care Authority (HCA) requirements

    • For nongrandfathered health plans issued or renewed on or after January 1, 2025 (and health plans offered to public and school employees), carriers may not impose cost‑sharing for the drugs that comprise at least one CDC‑recommended PEP regimen.
    • Health plans, Medicaid, and the HCA may not require prior authorization for those PEP drugs.
    • For plans that are HSA‑qualified, carriers must set cost‑sharing at the minimum level needed to preserve HSA tax status.
    • Health plans, Medicaid, and the HCA must reimburse hospitals, as a separate expense, for the 28‑day supply of PEP dispensed or delivered to emergency‑department patients for take‑home use.

Who is affected

  • Patients with possible recent HIV exposure (improved and faster access to an entire CDC‑recommended PEP regimen).
  • Hospitals and emergency departments (required to adopt policies, stock and dispense 28‑day supplies; administrative and inventory implications).
  • Health carriers, Medicaid, and the HCA (prohibited from imposing cost‑sharing and prior authorization for specified PEP regimens; required to reimburse hospitals).
  • Pharmacy operations, especially in rural/critical access areas (changes to stocking and prepackaged medication practices).

Implementation & fiscal notes

  • Effective January 1, 2025.
  • No appropriation in the bill; fiscal note(s) were prepared. Sponsors and proponents noted operational costs and medication shelf‑life concerns; the bill requires payer reimbursement to hospitals to address some financial impacts.

Legislative history (selected)

Introduced Jan 10, 2024; passed the Senate and House (unanimous recorded votes in final passage); delivered to Governor Mar 8, 2024; signed by Governor Mar 25, 2024. Public testimony emphasized barriers to timely PEP access, especially in rural areas, and supported the bill.

Compiled from official sources — confirm details with the bill’s official record.

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