Minnesota Department of Human Services Might Drop ADAP Recipients Who Owe Cost-Sharing Payments

The Minnesota Department of Human Services is planning to drop some HIV/AIDS patients who owe the state between $500 and $1,000 in cost-sharing payments from the state's AIDS Drug Assistance Program, the Minneapolis Star Tribune reports (Howatt, Minneapolis Star Tribune, 12/6). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 10/13). Approximately 675 HIV-positive individuals -- most of whom have annual incomes between 100% and 300% of the federal poverty limit -- are enrolled in the ADAP and are required to provide copayments between $1 and $3 per prescription drug with a $20 monthly limit. The copays can amount to between 1% and 7% of their incomes. So far, the state has dropped three people, who collectively owe $3,000, and eight other people, who together owe $4,000, might be cut this month. DHS Assistant Commissioner Loren Coleman said that although the state in 2004 made the decision to implement the fees because of budget shortfalls -- which were, in part, because of growing enrollment -- the cost-sharing option has allowed the state to avoid implementing waiting lists or other benefit changes. However, some critics say that being dropped from the program is too severe a penalty for recipients who cannot afford the fees. Frank Rhame of the Allina Medical Clinic in Minneapolis said, "There is a special need to maintain anti-HIV medications," adding, "When you omit HIV doses, you take a chance, depending on the circumstances, of your virus developing resistance." Coleman said the department is "continuing to try to seek solutions" for recipients cut from the program (Minneapolis Star Tribune, 12/6).