Senate approves bill requiring Medicaid reimbursement for pharmacists providing PrEP and PEP

The Oregon Senate on Monday passed House Bill 29 42, a measure requiring reimbursement under the Oregon Health Plan for pharmacists who prescribe and dispense pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention.

Senator Roberta Campos, speaking for the bill on the Senate floor, said the measure removes reimbursement barriers that have left Oregon Health Plan patients unable to access these services from pharmacists even though pharmacists were authorized by a 2021 law to prescribe and dispense PrEP and PEP. "This bill is about access and prevention. It is about making sure that a pharmacist who's legally allowed to provide this care can actually do so and be paid for it," Campos said.

Campos told senators that PEP, taken after potential exposure to HIV, can reduce the risk of transmission by about 80 percent if taken within 72 hours, and that PrEP can be roughly 99 percent effective when used as prescribed. She said HIV cases in Oregon have been rising to levels not seen since 2013 and framed the bill as both a health access and cost-saving measure; on the floor she cited an estimate that preventing a case of HIV avoids hundreds of thousands of dollars in lifetime treatment costs.

The sponsor said 2021 legislation (House Bill 2958) allowed pharmacists to prescribe, dispense, and administer PrEP and PEP, but commercial insurers were required to cover those services while Oregon Health Plan patients were excluded; HB 29 42 removes that reimbursement disparity by directing OHA and coordinated care organizations to reimburse pharmacists and pharmacies for these services.

Senators offered no extended debate on the floor. The clerk called the roll and the bill was recorded as having passed on third reading.