Pending Medicare National Coverage Determination (NCD) for HIV PrEP: What It Could Mean for PrEP Access

February 21, 2024 Pending Medicare National Coverage Determination (NCD) for HIV PrEP: What It Could Mean for PrEP Access Under federal law, the Centers for Medicare and Medicaid Services (CMS), the agency that oversees the Medicare program, can ensure coverage of preventive services under Medicare Part A and Part B through a process called a National Coverage Determination (NCD). [...] CMS may use the NCD process to decide to cover a preventive service in Medicare Part A or Part B, but if the service has a grade A or B from the U. [...] Services may be covered by Medicare even without an How Does Medicare Currently Cover Oral and NCD at the discretion of local entities charged with Injectable Forms of PrEP? making regional decisions about Medicare Part A and B • Oral medications are typically covered under coverage, but the NCD is necessary to create a federal the Medicare Part D benefit, which is provided mandate for coverage fo. [...] The comments applauded the • Coverage of oral medications for PrEP, which are currently covered move to make PrEP more under the Medicare Part D benefit, would be moved to Medicare affordable for Medicare Part B. [...] CMS may use the NCD process to decide to cover a preventive service in Medicare Part A or Part B, but if the service has a grade A or B from the U.