Pharmacy Benefits Manager Toolkit
Planning and implementation steps when using a Pharmacy Benefit Manager (PBM) to administer an AIDS Drug Assistance Program (ADAP).
Resource updated 09/19/2023
Planning and implementation steps when using a Pharmacy Benefit Manager (PBM) to administer an AIDS Drug Assistance Program (ADAP).
Resource updated 09/19/2023
Resource updated 02/22/2024
Pre-application webinars for Notice of Funding Opportunity (NOFO) announcements from HRSA's HIV/AIDS Bureau for the Ryan White HIV/AIDS Program (RWHAP).
Resource updated 03/07/2024
Trainings for Ryan White HIV/AIDS Program (RWHAP) recipients, subrecipients, and consultants regarding changes in the treatment of costs under the 10 percent administrative cap.
Resource updated 09/19/2023
A 2014 blog on how a Ryan White HIV clinic negotiated with a health plan, with lessons learned for agencies seeking coverage for the new treatment long-acting injectables.
Blog updated 03/25/2024
Cross-post of a guest editorial by Dr. Laura Cheever, HRSA Associate Administrator for HIV/AIDS, from Leading with Race, NMAC.
Blog updated 01/07/2021
Tool for conducting a cost analysis (determining the unit/average cost of a service) for purposes of billing and securing reimbursement for services provided.
Resource updated 03/05/2024
Federal agency that administers the Ryan White HIV/AIDS Program (RWHAP), which helps low-income people with HIV receive care.
Resource updated 12/22/2023
Tool for assessing your organization’s strengths and gaps in areas that (1) are important to insurers and (2) support maximizing revenue from contracting activities.
Resource updated 10/05/2023
Insights to ADAP procedures for seeking rebates when a prescription is filled by another 340B entity pharmacy.
Resource updated 03/05/2024
Scorecard template for use in keeping parties involved in RWHAP Part A planning informed about funds allocated to service areas. Also for the outcomes in terms of costs and care outcomes.
Resource updated 09/19/2023
Steps agencies can take to bill for services that enhance their financial sustainability.
Resource updated 10/05/2023
Manual on the GCMS data-storage system for RWHAP recipients to manage agency RWHAP contracts.
Resource updated 09/19/2023
Fact sheet to explain policies and procedures for ADAPs to follow to ensure that Ryan White funds are used as the payer of last resort, including for Medicaid.
Resource updated 09/14/2023
Building the capacity of RWHAP Part A Planning Councils/Planning Bodies to meet legislative requirements, strengthen consumer engagement, and increase planning involvement by community stakeholders/providers. Project period: 2020-2023.
RWHAP Technical Assistance Provider updated on 03/04/2024
TA/training to ASOs and CBOs most in need of critical assistance to make changes in health care delivery and financing.
RWHAP Technical Assistance Provider updated on 08/28/2023
HHS has supported development of a toolkit on state Medicaid and health department coordination to improve HIV care delivery.
Blog updated 12/28/2022
Review of how RWHAP Part B programs develop, maintain, and evaluate service standards for all funded services, per Policy Clarification Notice (PCN) 16-02.
Resource updated 09/14/2023
Series of tools to assist agencies as they undertake transformation to status as a Patient-Centered Medical Home (PCMH).
Resource updated 09/19/2023
Resource updated 08/28/2023