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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 204 Chapter 1 Application/Redetermination Process

1.23 AIDS DRUG ASSISTANCE PROGRAM (ADAP) The AIDS Drug Assistance Program (ADAP), or also referred to as the AIDS Special Pharmacy Program or the ADAP West Virginia Special Pharmacy Program, is a Bureau of Public Health (BPH) program contracted with BMS to administer the medical services provided. The eligibility decision is made by the AIDS Drug Assistance Program (ADAP), rather than the Worker. 1.23.1 APPLICATION FORMS • DFA-2, Single-Streamlined Application (SLA), or WV PATH – The DFA-2 is completed to determine Medicaid eligibility. • ADAP Application – If determined ineligible for all full-coverage Medicaid groups except an SSI-Related Medicaid with an unmet spenddown, an ADAP application for West Virginia Special Pharmacy must be completed. This application is available on the Department of Human Services (DOHS) Intranet Forms page. 1.23.2 COMPLETE APPLICATION The ADAP application is complete when page 1 is signed by the applicant and page 2, the Physician’s Report, is signed by the physician. 1.23.3 DATE OF APPLICATION The date of application is the date the Department of Human Services (DOHS) receives the application in person, by fax or other electronic transmission, through WV PATH or the Federally Facilitated Marketplace (FFM), or by mail, which contains, at a minimum, the applicant’s name and address and signature. NOTE: The resource development policies in Chapter 8 do not apply to ADAP. Potential eligibility for, or receipt of Medicare, Part D, does not affect the application or referral process for the ADAP eligibility determination.

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Page 237

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 204 Chapter 1 Application/Redetermination Process

1.23 AIDS DRUG ASSISTANCE PROGRAM (ADAP) The AIDS Drug Assistance Program (ADAP), or also referred to as the AIDS Special Pharmacy Program or the ADAP West Virginia Special Pharmacy Program, is a Bureau of Public Health (BPH) program contracted with BMS to administer the medical services provided. The eligibility decision is made by the AIDS Drug Assistance Program (ADAP), rather than the Worker. 1.23.1 APPLICATION FORMS • DFA-2, Single-Streamlined Application (SLA), or WV PATH – The DFA-2 is completed to determine Medicaid eligibility. • ADAP Application – If determined ineligible for all full-coverage Medicaid groups except an SSI-Related Medicaid with an unmet spenddown, an ADAP application for West Virginia Special Pharmacy must be completed. This application is available on the Department of Human Services (DOHS) Intranet Forms page. 1.23.2 COMPLETE APPLICATION The ADAP application is complete when page 1 is signed by the applicant and page 2, the Physician’s Report, is signed by the physician. 1.23.3 DATE OF APPLICATION The date of application is the date the Department of Human Services (DOHS) receives the application in person, by fax or other electronic transmission, through WV PATH or the Federally Facilitated Marketplace (FFM), or by mail, which contains, at a minimum, the applicant’s name and address and signature. NOTE: The resource development policies in Chapter 8 do not apply to ADAP. Potential eligibility for, or receipt of Medicare, Part D, does not affect the application or referral process for the ADAP eligibility determination.