We are submitting this formal complaint against Blue Cross Blue Shield of Mississippi (BCBSMS) regarding certain formularies offered on the individual and fully insured markets in Mississippi. First, BCBSMS is violating federal preventive health coverage requirements by covering only one of four pre-exposure prophylaxis (PrEP) medications to prevent HIV. Second, BCBSMS’ medical policy deeming long-acting injectables for the treatment of HIV “not medically necessary” does not allow for a meaningful formulary exceptions process as required by federal Essential Health Benefit (EHB) regulations.
Letter to Massachusetts Budget Conference Committee supporting FY27 HIV PrEP access provisions and HIV/AIDS funding
As you work to reconcile the Massachusetts Fiscal Year 2027 budget, we write to thank you for your longstanding leadership and advocacy on behalf of the HIV community. We respectfully urge the Conference Committee to adopt two critical HIV priorities passed by the House: (1) the comprehensive HIV PrEP access provisions, and (2) the robust $35 million funding level for the state’s HIV/AIDS and infectious disease programs.
Senate testimony on FY27 HIV and hepatitis program appropriations
In order to achieve successful implementation of the National HIV/AIDS Strategy (NHAS), EHE and viral hepatitis programs, resources are needed to strategically coordinate HIV and viral hepatitis activities across the federal government. We urge you to fund the HHS Office of Infectious Disease and HIV/AIDS Policy at $7.6 million.
Letter to all Medicaid expansion states requesting HIV exemption from community engagement requirements
People with serious and complex medical conditions or special medical needs are statutorily exempt from the community engagement requirement. Federal implementation guidance due by June is expected to provide further detail on how states may implement this exemption. While we are seeking a federal exemption, under the law, states are allowed to define which populations qualify for the exemption. We urge Alaska Medicaid to explicitly state that HIV is a serious and complex medical condition and that all people living with HIV (both symptomatic and asymptomatic) have special medical needs and fall under this exemption.
Letter to Michigan Senate supporting bill to ensure copay assistance counts for patients
By passing SB 914, Michigan will join 26 other states, the District of Columbia, and Puerto Rico in protecting consumers purchasing insurance on the private market. This legislation ensures that copay assistance counts toward cost-sharing obligations, preventing patients from facing insurmountable financial barriers to their medications.