July 28, 2014
|State||Number of Individuals on ADAP Waiting List||Percent of the Total ADAP Waiting List||Increase/Decrease From Previous Reporting Period||Date Waiting List Began|
Waiting List Organization: Waiting list clients are prioritized by one of two models:
Access to Medications: Utah confirms that case management services assist clients in obtaining medications through the HarborPath ADAP waiting list program or pharmaceutical company patient assistance programs (PAPs) while clients are on the waiting list.
The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies passed their version of the FY2015 Labor-HHS-Education Appropriations bill, which flat funded ADAPs. Though both House and Senate leadership indicated that appropriations would take place under "regular order," the full Senate Appropriations Committee will likely not mark up their version of the bill until after the November elections. There is no House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies markup scheduled and it is now also rumored to be postponed until after the November elections. There will most likely be a short term continuing resolution funding the government until after the November elections. Depending on the outcome of the elections, there may be another continuing resolution until the start of the new Congressional session in January 2015.
|Enrollment Cap||Expenditure Cap||Financial Eligibility||Formulary Reduction||Other|
|Arizona: (monthly: insurance premiums of $350); (annual: medical copayment of $3000)
South Dakota: (annual)
|Georgia: cap on insurance premiums
Montana: service reductions in place
|Enrollment Cap||Formulary Reduction||Waiting List|
In April, Alaska and Louisiana reported anticipating new cost-containment measures. As of the latest ADAP Watch survey, they both no longer anticipate these new measures due to internal system reviews. Alaska was able to keep their formulary unchanged after reviewing their overall utilization data. Louisiana was able to avoid establishing an enrollment cap and wait list due to implementation of a new pharmacy benefit management contract and changes in the state's fiscal review process that has allowed for more efficient and timely rebate processing.
|Enrollment Cap||Expenditure Cap||Formulary Reduction||Other|
|New Mexico||Utah||Oklahoma: increase financial eligibility to 400% for individuals with insurance; 200% for uninsured.|
Washington: stopped requiring use of PAPs during insurance enrollment
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