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BREAKING NEWS: California cancels contract with ADAP administrator; HIV advocates hopeful for a better system

, by Emily Newman

In a move to fix ongoing service provision problems by the AIDS Drug Assistance Program (ADAP), the California Department of Public Health announced today that they have terminated a contract with ADAP administrator A.J. Boggs, effective March 31. This decision comes after continuing complaints from ADAP clients and enrollment workers, and pressure from HIV advocacy groups and key members of the legislature concerned about the frustrations and difficulties that people living with HIV have been experiencing with the ADAP system.

Enrollment workers and HIV advocates are optimistic about the decision, and hopeful that the change will bring about much-needed improvements to the ADAP system.

Courtney Mulhern-Pearson

“We are thankful that the State Office of AIDS has responded to our requests for change,” said Courtney Mulhern-Pearson, director of state and local policy at San Francisco AIDS Foundation. “The last seven months have been extremely disruptive for clients trying to obtain their medication through ADAP, and many of them have been denied coverage since the switch to A.J. Boggs. We want to make sure that people living with HIV in our state are never without coverage or care for the medications they need.”

A.J. Boggs has been one of three ADAP administrators since July 2016, when the California Department of Public Health switched from one long-standing ADAP administrator (Ramsell) to three new contractors: A.J. Boggs (responsible for program eligibility and enrollment), Magellan Rx (pharmacy benefits management) and Pool Administrators Inc. (OA-HIPP and Medicare Part D premium payment programs). Contracts with Magellan Rx and Pool Administrators Inc. will remain in effect.

The switch to the three new contractors last summer has been described as “contentious,” and has resulted in a variety of problems for clients who have had their applications lost, coverage dropped and difficulties accessing their medications. Ellen Novogrodsky, financial benefits counselor at San Francisco AIDS Foundation, reported last fall that it wasn’t unusual for her to get a few calls every week from clients having trouble getting their prescriptions at the pharmacy after the contractor switch.

“I think a change was definitely needed,” Novogrodsky told BETA today. “I am excited and hopeful that the new system will work well to insure that participants are able to get their medications quickly and without any disruptions.  I am hoping for a smooth transition.”

The California Department of Public Health has established an ADAP call center and data processing unit in order to offer ADAP eligibility and enrollment services starting March 6, according to an update released by the Department of Public Health today. The update also specified that the Department of Public Health has worked with an independent consulting firm to create a new ADAP enrollment system, and that enrollment workers will be trained on the new system starting the week of March 13.

What to know if you are an ADAP client

  • You will get a new Magellan Rx card in the mail.
  • ADAP clients who have been granted an extension to re-enroll in ADAP through June 30 will need to meet with their ADAP eligibility worker to see if they still meet the eligibility requirements.
  • If you are due to complete a self-verification form in March or April, those self-verification forms have already been sent out in the mail by A.J. Boggs. See your ADAP enrollment worker if you have questions about how to complete those forms.
  • Call or see your ADAP enrollment worker if you have any additional questions or problems accessing your medications.

Need help with ADAP? Contact the San Francisco AIDS Foundation Financial Benefits program if you are living with HIV and in the San Francisco Bay Area, and need assistance with services programs including ADAP, Food Stamps, Medi-Cal, Medicare, OA-HIPP, and Social Security. Or call 415.487.8000 if you’d like more information or to schedule an appointment with a benefits counselor.

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