H.R. 9946: Equity in STI Testing Act

This bill would require more health plans and federal health programs to cover certain sexually transmitted infection (STI) tests without charging patients out of pocket.

What tests are covered

The bill focuses on screening tests for:

• HIV
• Gonorrhea
• Syphilis
• Trichomoniasis
• Chlamydia

It also covers the administration of those tests, meaning the act of giving the test itself would be included in the coverage.

Where the changes would apply

The bill would extend this no-cost coverage requirement across several programs:

• Medicare Advantage: These plans would have to include the listed STI screenings as a covered preventive service.
• Medicaid: State Medicaid programs would have to cover the tests, and beneficiaries could not be charged cost-sharing for them.
• CHIP (the Children’s Health Insurance Program): Coverage would be required for the listed screenings for eligible children, without cost-sharing.
• TRICARE: Military health coverage would have to include these screenings for covered beneficiaries, including members of TRICARE Prime, TRICARE Select, and certain other military health care arrangements, without cost-sharing.
• Veterans Health Care: The Department of Veterans Affairs would have to provide these screenings to enrolled veterans at VA medical facilities without copayments or other charges.
• Indian Health Service: The federal government would have to cover these screenings for Indians receiving health services through the Indian Health Service, including Urban Indian Organizations, without cost-sharing.

Cost-sharing changes

For the programs covered by the bill, patients generally could not be required to pay copayments, deductibles, or similar out-of-pocket costs for these STI screenings.

Timing

The bill sets different effective dates depending on the program:

• Some changes would take effect on the date the bill is enacted.
• For Medicaid and CHIP, the new requirements would generally apply starting with calendar quarters beginning one year after enactment, with a delay if a state needs to pass its own legislation to comply.
• TRICARE changes would take effect on January 1 of the year after enactment.
• Veterans and Indian Health Service provisions would also apply on the dates specified in the bill, generally beginning after enactment or at the start of the next calendar year.

Relevant Companies

None found