Request for Comment on DRAFT New Bulletin B-4.1XX - HIV PrEP Ancillary Services

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The Division is seeking informal comments on the following draft new bulletin:

New Bulletin B-4.1XX - Policy Directives for Coverage of HIV Prevention Ancillary Services


Colorado law, 10-16-104(18) C.R.S., requires insurers, excluding grandfathered health plans, to cover items or services that have a rating of “A” or “B” in the current  recommendations of the United States Preventive Services Task Force (“USPSTF”) without cost-sharing. The USPSTF issued an “A”-rated recommendation that clinicians offer pre-exposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of human immunodeficiency virus (HIV) acquisition. The Division of Insurance (Division) adopted Regulation 4-2-73 concerning coverage of PrEP consistent with the USPSTF recommendations beginning January 1, 2021. The purpose of this bulletin is to provide guidance to insurers regarding health insurance coverage for tests and services related to PrEP adherence, including baseline and follow-up testing and monitoring.

This bulletin is intended to provide guidance to all insurers marketing and issuing health
benefit plans, including student health plans, in the State of Colorado on or after January 1, 2021. This bulletin does not apply to grandfathered plans.

The Division is requesting informal comments be submitted to DORA_INS_RulesandRecords@state.co.us no later than 5 PM, December 9, 2020.

This draft bulletin, as well as other draft bulletins currently released for informal public comment, can be found on our page for Draft Regulations and Bulletins for Informal Comments

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