2694 AIDS Drug Assistance Program (ADAP)

Limited coverage is available for persons diagnosed with AIDS. Coverage is limited to payment of prescription drugs related to treatment of AIDS as provided in an ongoing formulary. KDHE has ultimate responsibility for the program, including budget, claims payments and case processing. KDHE-DHCF eligibility staff are not responsible for the eligibility determination or case maintenance of these cases.

Eligibility information is entered into KEES and then sent to the fiscal agent and is displayed on MMIS. Providers bill the MMIS for medications provided to the ADAP eligible client. Persons may be eligible for Medicaid or MediKan coverage as well as ADAP. Payment for claims is generally drawn from Medicaid funds, except when noted.

Persons may be eligible for one of three separate ADAP coverage groups:

Ryan White Program - services for persons eligible under this group are federally funded.

ADAP State Assistance - a state-funded program which provides assistance to persons eligible under the medically needy program attempting to meet a spenddown (see 7532.3 ) When a provider appropriately bills an expense for an ADAP-eligible client, the expense will be paid and it will also be applied to the medically needy spenddown.

ADAP Tracking Only - persons eligible under this category do not receive any benefits but are captured for tracking purposes only.