SB 6127 — Increasing access to human immunodeficiency virus postexposure prophylaxis drugs or therapies.

ENGROSSEDS-3744.1 SUBSTITUTE SENATE BILL 6127 State of Washington 68th Legislature 2024 Regular Session By Senate Health & Long Term Care (originally sponsored by Senators Liias, Rivers, Muzzall, Randall, Frame, Hasegawa, Kuderer, Lovick, Nobles, and Pedersen)Pedersen READRead FIRSTfirst TIMEtime 01/29/24.01/10/24.

Referred to Committee on Health & Long Term Care.

reenacting and amending RCW 41.05.017;

adding a new section to chapter 48.4343.70 RCW;

and adding a new section to chapter 74.0948.43 RCW;RCW.

and providing an effective date.

(2) This policy must ensure that hospital staff dispense or deliver to a patient, with a patient's informed consent, at least a five-day supply of human immunodeficiency virus postexposure prophylaxis drugs or therapies following the patient's possible exposure to human immunodeficiency virus, unless medically contraindicated,contraindicated. inconsistent with care and treatment standards, or inconsistent with centers for disease control and prevention guidelines.

When p.

1 ESSB 6127 available, hospitals shall dispense or deliver generic human immunodeficiency virus postexposure prophylaxis drugs or therapies.

(3) Nothing in this section shall be construed to alter the coverage for reimbursement of postexposure prophylaxis drugs through:

(a) The crime victims' compensation program, established in chapter 7.68 RCW, for drugs dispensed or delivered to sexual assault victims;

or (b) The industrial insurance act for drugs dispensed or delivered to a worker exposed to the human immunodeficiency virus through the course of employment.

(1)p. The legislature finds that high quality, safe, and compassionate health care services for patients of Washington state must be available at all times.

1 SB 6127 (1) The legislature finds that high quality, safe, and compassionate health care services for patients of Washington state must be available at all times.

((or))or (b) When, in the judgment of the practitioner and consistent with hospital policies and procedures, a patient has no reasonable ability to reach the local community or outpatient pharmacy;pharmacy.

or (c) When a patient is identified as needing human immunodeficiency virus postexposure prophylaxis drugs or therapies.

The director of the hospital pharmacy, in collaboration with appropriate hospital p.medical staff, develops policies and procedures regarding the following:

2 ESSB 6127 medical staff, develops policies and procedures regarding the following:

(d) Assurances that any practitioner authorized to prescribe prepackaged emergency medication or any nurse authorized to distribute prepackaged emergency medication is trained on the types ofp. medications available and the circumstances under which they may be distributed;

2 SB 6127 of medications available and the circumstances under which they may be distributed;

(f) Establishment of a limit of no more than a 48 hour supply of emergency medication as the maximum to be dispensed to a patient, except when community or hospital pharmacy services will not be available within 48 hours((.hours.

In no case may the policy allow a supply exceeding 96 hours be dispensed)),dispensed; or when antibiotics or human immunodeficiency virus postexposure prophylaxis drugs or therapies are required;

p.(5) Nothing in this section restricts the authority of a practitioner in a hospital emergency department to distribute opioid overdose reversal medication under RCW 69.41.095.

3(6) ESSB 6127 (5) Nothing in this section restricts the authority of a practitioner in a hospital emergency department to distribute opioidhuman overdoseimmunodeficiency reversalvirus medicationpostexposure underprophylaxis RCWdrugs 69.41.095.or therapies in accordance with section 1 of this act.

(6)(7) A practitioner or a nurse in a hospital emergency department must dispense or distribute opioid overdose reversal medication in compliance with RCW 70.41.485.

(7)(((7))) (8) For purposes of this section:

(c)p. "Opioid overdose reversal medication" has the same meaning as provided in RCW 69.41.095.

3 SB 6127 (c) "Opioid overdose reversal medication" has the same meaning as provided in RCW 69.41.095.

A new section is added to chapter 48.4343.70 RCW to read as follows:

(1)Once Excepteach ascalendar providedyear, inthe subsectiondepartment (2)shall ofprovide thisto section,each forhospital nongrandfathereddesignated healthas plansa issuedcritical oraccess renewedhospital, onat orno aftercost Januaryto 1,the 2025,hospital, aone health30-day carriersupply mayof nothuman imposeimmunodeficiency costvirus sharingpostexposure orprophylaxis require prior authorization for the drugs thator comprisetherapies, atunless leastrefused one regimen recommended by the centershospital forunder diseaseRCW control48.43.065. and prevention for human immunodeficiency virus postexposure prophylaxis.

(2) For a health plan that is offered as a qualifying health plan for a health savings account, the health carrier must establish the plan's cost sharing for the coverage required by this section at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions and withdrawals from the enrollee's health savings account under the internal revenue service laws and regulations.

(3) Notwithstanding the coverage requirements of this section, a health plan shall reimburse a hospital that bills for a five-day supply of any human immunodeficiency virus postexposure prophylaxis p.

4 ESSB 6127 drugs or therapies dispensed or delivered to a patient in the emergency department for take-home use, pursuant to section 1 of this act, as a separate reimbursable expense.

This reimbursable expense is separate from any bundled payment for emergency department services.

A new section is added to chapter 74.0948.43 RCW to read as follows:

(1) AllExcept medicaidas contractedprovided managedin caresubsection organizations(2) shallof providethis coveragesection, withoutfor priorhealth authorizationplans forissued theor drugsrenewed thatafter compriseDecember at31, least2024, onea regimenhealth recommendedcarrier bymay thenot centersimpose forcost diseasesharing controlor andrequire preventionprior authorization for all human immunodeficiency virus postexposure prophylaxis.prophylaxis drugs or therapies.

(2) NotwithstandingFor thea coveragehealth requirementsplan ofthat thisis section,offered as a medicaidqualifying contractedhealth managedplan carefor organizationa shallhealth reimbursesavings aaccount, hospitalthe thathealth billscarrier formust aestablish five-daythe supplyplan's ofcost anysharing humanfor immunodeficiencythe viruscoverage postexposurerequired prophylaxisby drugsthis orsection therapiesat dispensedthe orminimum deliveredlevel necessary to apreserve patientthe inenrollee's theability emergencyto departmentclaim fortax take-homeexempt use,contributions pursuantand towithdrawals sectionfrom 1the ofenrollee's thishealth act,savings asaccount aunder separatethe reimbursableinternal expense.revenue service laws and regulations.

This reimbursable expense is separate from any bundled payment for emergency department services.

Sec.

5.