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ENROLLED ORIGINAL
AN ACT
D.C. ACT 26-277
IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
MARCH 20, 2026
‘ToamendtheProhibitionofDiscriminationintheProvisionofInsuranceActof1986toprohibithealthbenefitplansandhealthinsurersfromfactoringtheuseofHIVpreventiontreatmentindecisionsrelatedtotheissuanceofdisability,life,orlong-termcare
insurancepolicies,imposingcostsharing,priorauthorization,ormedicallyunnecessaryrestrictionsonHIVpreventionservices,PEP,oranyformulationofPrEP,andusingprescriptioninformationforHIVpreventiontreatmentformedicalunderwritingforindividualpatients;andtoamendtheDepartmentofHealthFunctionsClarificationActof 2001toestablishanon-lapsingDC HealthandWellnessCenterFundtocollect,
revenuefrominsuranceandout-of-pocketcostspaidforservicesprovidedbytheDCHealthandWellnessCenterandaffiliatedclinics,andtorequirethefindsbespentsolely
ontheoperationsoftheDC HealthandWellnessCenterandaffiliatedclinics.
BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
actmay be citedas the“PrEP DC Amendment Actof 2026”.
Sec.2.TheProhibitionofDiscriminationintheProvisionofInsuranceActof1986,effectiveAugust7,1986(D.C.Law6-132;D.C.OfficialCode§31-1601efseg.),isamendedas
follows:(a)Section2(D.C.OfficialCode§31-1601)isamendedasfollows:(1)Newparagraphs(2A)and(2B)areaddedtoreadasfollows:(2A)“Baselineassessment”meansanytesting,asrecommendedbytheU.S.CentersforDiseaseControlandPrevention,tobecompletedbeforeprescribingHIVprevention
medication,includingscreeningtestsforchlamydia,gonorrhea,syphilis,kidneyfunction
assessments,hepatitisB virusserology,andlipidprofiles.“(2B)“Commissioner”meanstheCommissioneroftheDepartmentofInsurance,
Securities,andBanking.”(2)A newparagraph(3B)isaddedtoreadasfollows:“(@B)“Healthbenefitplan”shallhavethesamemeaningasprovidedinsection101(20)oftheHealthInsurancePortabilityandAccountabilityFederalLawConformityandNo-
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ENROLLED ORIGINAL
FaultMotor VehicleInsuranceAct of 1998,effectiveApril13,1999 (D.C.Law 12-209;D.C.
Code§31-3301.01(20)).”.
(3)New paragraphs(5A)and(5B)areaddedtoreadasfollows:
“(SA)“HIVpreventionservices”meansmedicalservicestopreventHIVand
AIDS,includingbaselineassessments,initialandfollow-upappointmentsandservices,
medicationforthemanagement of sideeffectsassociatedwith PrEP and PEP, and medication
self-managementoradherencecounseling.
“(5B) “HIV preventiontreatment”means medicaltreatmentused topreventHIV,
includingPrEP, PEP, and HIV preventionservices.”.
(4)Newparagraphs(7A)and(7B)areaddedtoreadasfollows:
“(7A)“PrEP”meanspre-exposureprophylaxisantiretroviralmedicationapproved
by theU.S. Food and Drug Administration(“FDA”) used topreventHIV ina personwithout
HIV.
(7B)“PEP”meanspost-exposureprophylaxisantiretroviralmedicationapproved
bytheFDAusedtopreventHIVinapersonwithoutHTVwhomayhavebeenrecentlyexposed
to HIV.”.
(b)Section4 (D.C.OfficialCode § 31-1603)isamended as follows:
(1)Subsection(b)isamended to readas follows:
“(b)(1)Indeterminingwhethertoissue,cancel,orrenewinsurancecoverage,aninsurer
maynot:
“(A)Useage,maritalstatus,geographicareaofresidence,occupation,
sex,sexualorientation,genderidentityorexpression,oranysimilarfactororcombinationof
factorsforthepurposeofseekingtopredictwhetheranyindividualmayinthefuturedevelop
AIDS or ARC; or
“(B)Take intoconsiderationan individual’suse of HIV prevention
treatmentwhen takenpursuantto avalid prescriber’sorder.
“(2)Indeterminingrates,premiums, dues,assessments,benefitscovered,or
expensesreimbursable,orinanyotheraspectofinsurancemarketingorcoverage,aninsurer
maynot:
“(A)Useage,maritalstatus,geographicareaofresidence,occupation,
sex,sexualorientation,genderidentityorexpression,orany similarfactororcombinationof
factorsforthepurposeofseekingtopredictwhetheranyindividualmay inthefuturedevelop
AIDS or ARC; or
“(B)Take intoconsiderationan individual’suse of HIV prevention
treatmentwhen takenpursuantto a validprescriber’sorder.”.
(2)Subsection(c)isamendedtoreadasfollows:
“(c)No healthor disabilityinsurancepolicyor contractshallcontainany exclusion,
reduction,otherlimitationof coverage,deductibles,or coinsuranceprovisionsrelatedtoHIV
preventiontreatmentorthecareand treatmentof AIDS, ARC, HIV infection,or any illnessor
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ENROLLED ORIGINAL
diseasearisingfromthesemedicalconditions,unlesstheprovisionsapplygenerallytoall
benefitsunderthepolicyorcontract.”
(c)Section5 (D.C.OfficialCode § 31-1604)isamended as follows:
(1)Subsection(a)isamendedasfollows:
(A)Paragraph(1)isamendedbystrikingthephrase“DistrictofColumbia
Commissioner of PublicHealth(“Commissioner”)”and insertingthephrase“Directorof the
DepartmentofHealth(“Director”)”initsplace.
(B)Paragraph(2)isamendedbystrikingtheword“Commissioner”and
insertingtheword“Director”initsplace.
(2)Subsection(b)isamendedasfollows:
(A)Paragraph(1)isamendedtoreadasfollows:
“(b)(1)A namedinsuredwhotestspositiveunderthetestingprotocolcertifiedbythe
Directormay appealtotheCommissioner toreviewthetestingproceduresand results,and may
presentadditionalmedicalevidence,includingtheresultsofsimilartestsforexposuretothe
probablecausativeagentof AIDS thatthenamed insuredindependentlyobtains,to rebutthe
positivetestresults.IftheCommissionerdeterminesthattheresultofthetestoftheproposed
insuredisnota truepositive,theCommissioner shallordertheinsurerfrom which theapplicant
soughtcoveragetodisregardthepositivetestresult.TheCommissionershall,whennecessary,
requesttheadviceoftheDirectorinmakingthisdetermination.”.
(B) Paragraph(3)isamended by strikingtheword “Commissioner” and
insertingtheword“Director”initsplace.
(@)Section9(D.C.OfficialCode§31-1608)isamendedbyaddinganewsubsection(b-
1)toreadasfollows:
“(b-1)Any personwho violatessection4 shallbe finednotlessthan$1,000,and not
more than$10,000foreach violation.”.
(e)Section10 (D.C. OfficialCode § 31-1609)isamended as follows:
(1)Theexistingtextisdesignatedassubsection(2).
(2)Anew subsection(b)isaddedtoreadasfollows:
“(b)The Mayor, pursuantto TitleI oftheDistrictof Columbia AdministrativeProcedure
Act,approved October21, 1968 (82 Stat.1204; D.C.OfficialCode § 2-501 efseq.),may issue
rulesto implement theprovisionsof section12.”.
(f)A new section12 isadded to readasfollows:
“Sec.12.Coverage forHIV preventiontreatment.
“(a)(1)Except as otherwiseprovidedinsubsection(b)of thissection,forhealthbenefit
plansissuedorrenewedonorafterJanuary1,2027,aninsurermaynotimposecostsharing,
requirepriorauthorization,orimposeanymedicallyunnecessaryrestrictionsordelaysforthe
coverageof HIV preventionservices,PEP, or any formulationof PrEP. _ “(b)Subsection(a)of
thissectionshallnot applytotheextentthatcoveragewithoutcost-sharingwould disqualifyan
individualreceivingcoverageunder a high deductiblehealthplanfrom eligibilityfora health
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ENROLLED ORIGINAL
savingsaccountpursuantto26U.S.C.§223.
“(c)No healthbenefitplanorinsurermayuseprescriptioninformationindicatingtheuse
ofHIVpreventiontreatmenttomedicallyunderwritepremiumsforspecificenrollees.
“(d)Forthepurposesofthissection,theterm“medicallyunnecessaryrestrictions”means
steptherapy,waitingperiods,orpreexistingconditionexclusions.”
Sec.3.TheDepartmentofHealthFunctionsClarificationActof2001,effectiveOctober3,2001(D.C.Law14-28;D.C,OfficialCode§7-731efseq.),isamendedbyaddinganew
section4907gtoreadasfollows:“Sec,4907g.DC HealthandWellnessCenterFund.“(a)ThereisestablishedasaspecialfundtheDC HealthandWellnessCenterFund(“Fund”),whichshallbeadministeredbytheDepartmentofHealthinaccordancewithsubsection(¢)ofthissection.“(b)AllpaymentsmadeforservicesrenderedattheDC HealthandWellnessCenterand
affiliatedclinicsshallbedepositedintheFund,including:“(1)Paymentsreceivedfromthird-partyinsurancereimbursements;“(2)Out-of-pocketpaymentscollectedfromindividuals;and“(3)Othercollections.“(c)MoneyintheFundshallbeusedsolelytosupporttheoperationsoftheDC Health
andWellnessCenterandaffiliatedclinies.“(d)(1)ThemoneydepositedintotheFund,includinganyinterestearned,butnotexpendedinafiscalyearshallnotreverttotheunassignedfundbalanceoftheGeneralFundoftheDistrictofColumbiaattheendof fiscalyear,oratanyothertime.
(2)Subjecttoauthorizationinanapprovedbudgetandfinancialplan,anyfundsappropriatedintheFundshallbecontinuallyavailablewithoutregardtofiscalyearlimitation.”.
Sec.4,Fiscalimpactstatement.TheCounciladoptsthefiscalimpactstatementinthecommitteereportasthefiscalimpactstatementrequiredbysection4aoftheGeneralLegislativeProceduresActof1975,approvedOctober16,2006(120Stat.2038;D.C.OfficialCode§1-301.47a).
Sec.5,Effectivedate.
ThisactshalltakeeffectafterapprovalbytheMayor(orintheeventofvetobythe
ENROLLED ORIGINAL
Mayor,actionbytheCounciltooverridetheveto)anda30-dayperiodofcongressionalreview
asprovidedinsection602(c)(1)oftheDistrictofColumbiaHomeRuleAct,approvedDecember24,1973(87Stat.813;D.C.OfficialCode§1-206.02(c)(1)).
LPCouncilofthe Districtof Columbia
DistrictlofColumBia_APPROVEDMARCH 20, 2026
COUNCILOF THEDISTRICTOF COLUMBIA
WASHINGTON,DC,20004
DockstNo,826-0159
[]ITEMONCONSENTCALENDAR
[XTACTION FirstReading
[DavoTEDATE February3,2026
[x7VOICEVOTE Approved
RECORDEDVOTEONREQUEST
ABSENT
[]ROLLCALLVOTE-Resuit
‘CouncMember [Aye[Nayww [AB[Ree|CouncMember|Aye[Nay[NW]AB[Rec|Counct!Member[Aye[Nay|NV[AB[Ree
ChairmanMendelson]x Frumin x Pinto x
‘Alen x Henderson|X .Wie x
Bonds x LewisGeowe |X Tite x
Craword x Nadeau x
Folder x Parker x
X-IndleateVote A= Absent “ONV=Presont,NotVoting
CERTIFICATIONRECORD
2a aeraSeoreianoteCounet Date
DocketNo.B26-0159
UX] ITEM ON CONSENT CALENDAR:
[LX]ACTION FinalReading,CC
[X1VOTEDATE March3,2028
[LX]VOICE VOTE Approved
RECORDEDVOTEONREQUEST
ABSENT
[JROLLCALLVOTE~Resuit
GounciMember’-.[Aye[Nay[NV[AB [Rec[CounaiMember:[Aye[Nay[NV[AB[Ree[GouncitMember[Aye[Nay|Nv [AB[Reo
GhalrmanMendelson) Frain x Pinto
‘Alen x Henderson x R.wite
Bonds x LewisGeorge_| x T.wnite
Crawtord x Nadeau x
x Parker x
eae -NV=Present,NotVoting
CERTIFICATIONRECORD
SecretarytotheCounal