State Pharmacy Assistance Program for HIV/AIDS

Item 289 #3c

Language
Page 246, line 21, strike "$45,482,621" and insert "$45,782,621".
Page 246, line 21, strike "$45,482,621" and insert "$45,782,621".
Page 247, after line 15, insert:
"G.  Out of this appropriation, $300,000 the first year and $300,000 the second year shall be provided to establish a state pharmaceutical assistance program (SPAP) for insurance premium payments, coinsurance payments, and other out-of-pocket costs for individuals participating in the Virginia AIDS Drug Assistance Program (ADAP) with incomes between 135 percent and 300 percent of the federal poverty income guidelines and who are Medicare Part D beneficiaries."

Explanation
(This amendment provides funding to create a state pharmaceutical assistance program (SPAP) to cover the cost of prescription drugs that are not covered by the Medicare Part D program for HIV–positive individuals. The SPAP will pay individual's premiums, coinsurance and coverage for prescription drug expenses in the so-called “donut hole”, the gap in Medicare coverage between $2,850 and $5,100 for some beneficiaries with incomes above 150 percent of the federal poverty level. In addition, Medicare Part D requires individuals with income between 135 percent and 150 percent of poverty to pay 15 percent of their annual prescription drug expenses up to $5,100 in total expenditures, before qualifying for full coverage. It is estimated this would cost persons living with HIV/AIDS $200 to $300 per month. This program would help to ensure that medications are continuously available without interruption for persons living with HIV/AIDS who require medication to maintain health and prevent more costly illnesses.)