The California Department of Public Health has issued instructions regarding the Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) to minimize exposure to COVID-19 and maintain coverage. For clients with expiring eligibility or expired eligibility back to March 1, PreP-AP is extending eligibility for 90 days to June 30, 2020.
However, for clients in a Gilead Assistance Program, Gilead is not extending eligibility. Clients enrolled with expiring eligibility should submit a re-enrollment application with income documentation to Gilead prior to their eligibility ending to avoid a lapse in coverage.
If clients are unable to obtain their medication or submit a re-enrollment application before their eligibility expires, Gilead can provide the pharmacy override on a case-by-case basis. If Gilead does not allow a medication dispense, PrEP-AP may approve an override on a case-by-case basis.
Clients enrolled in Gilead’s Patience Assistance Program and Copayment Assistance Program can receive up to a 90-day fill of medication as long as there is eligibility throughout the 90 day time period. Clients in Gilead’s Copayment Assistance Program can only receive a 90 day dispense if their insurance allows for a 90-day prescription fill. Pharmacies must contact Gilead to get an override code. This is in effect until April 30, 2020.
Clinical providers are encouraged to consider converting PrEP to virtual if their agency has the capacity. PrEP-AP can reimburse telemedicine using the same billing code as for an in person visit. Providers are encouraged to reach out to client to inform them that in-person appointments are changing to telemedicine.
Providers are also asked to postpone services that require person-to-person interaction but will maintain access to in-person visits when needed based on the client’s symptoms such as acute HIV or a sexually transmitted infection. Laboratory testing for people on PrEP with good adherence and no symptoms can usually be postponed for 3 months. (Management Memorandum 20-08, March 20, 2020.)