PrEP Patient Assistance Program (PrEP-AP)

NYSDOH Program Reimburses Health Care Providers for Services

The NYSDOH has begun a Pre-exposure Prophylaxis Assistance Program (PrEP-AP) to reimburse health care providers for the costs associated with providing health care and laboratory services associated with PrEP to uninsured or under-insured patients.

The program will reimburse enrolled providers for a specific set of services including, but not limited to: HIV testing, counseling, STD testing, and supportive care services consistent with New York State’s HIV Clinical Guidelines:

Uninsured patients, or those with barriers to coverage, will be enrolled in the PrEP-AP program using the same enrollment infrastructure and basic eligibility criteria as the ADAP/HIV Uninsured Care Programs.   Enrolled providers can submit claims for the covered services provided to these PrEP-AP patients and will be reimbursed based on Medicaid primary care fee-for-service rates.  

Participating health care providers will be responsible for helping patients apply to the drug manufacturer’s patient assistance program to cover the cost of the medication. The HIV Uninsured Care Programs staff will also operate a PrEP hotline to help patients with this process or refer them to more comprehensive health care coverage.

For more information about how health care providers can participate in PrEP-AP, call 1-800-542-2437. For general information about PrEP, call the AIDS Institute’s Clinical Education Initiative at 1-866-637-2342.