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ADAP/Medicaid Coordination Examined in Policy Papers

Wednesday, September 12, 2018


A series of policy papers examines ways that states can coordinate HIV prescription drug coverage under their Medicaid and ADAP under the Ryan White HIV/AIDS Program. Such efforts have the potential to improve health outcomes and cut costs for people living with HIV (PLWH), whose medical cost are upwards of five times more than average Medicaid recipients.

The series, Improving Care for People Living with HIV: Opportunities for State Medicaid-Ryan White HIV/AIDS Program Collaboration, was released this summer, was funded by HRSA. 

Below are the three briefs and a few best practices highlights from each:

  • State Strategies to Improve Collaboration Between Medicaid and AIDS Drug Assistance Programs - alignment of Medicaid/ADAP formularies to minimize “fragmented coverage” and addressing barriers like prior authorization through exemptions for essential HIV drugs.
  • States Strengthen Medicaid-Ryan White Collaboration to Improve Care Coordination for People Living with HIV - data sharing, special needs managed care plans, health homes and Medicaid waivers like case management that would otherwise only be available in institutional settings.
  • Maintaining Access: State Strategies to Coordinate Eligibility between Medicaid and Ryan White Programs - coordinated eligibility processes to ease enrollment, monitoring and patient experiences.

See the policy papers and best practices developed under HRSA's ADAP Technical Assistance Program

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