(a)
- (1) Except as otherwise provided in subsection (b) of this section, for health benefit plans issued or renewed on or after January 1, 2027, an insurer may not impose cost sharing, require prior authorization, or impose any medically unnecessary restrictions or delays for the coverage of HIV prevention services, PEP, or any formulation of PrEP.
- (b) Subsection (a) of this section shall not apply to the extent that coverage without cost-sharing would disqualify an individual receiving coverage under a high deductible health plan from eligibility for a health savings account pursuant to 26 U.S.C. § 223.
- (c) No health benefit plan or insurer may use prescription information indicating the use of HIV prevention treatment to medically underwrite premiums for specific enrollees.
- (d) For the purposes of this section, the term "medically unnecessary restrictions" means step therapy, waiting periods, or preexisting condition exclusions.
History
Aug. 7, 1986, D.C. Law 6-132, § 12
May 21, 2026, D.C. Law 26-115, § 2(f)