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HIV and Enteropathy
Ryan White
Ryan White HIV/AIDS Program
The Ryan White Program is a federal program designed specifically for the care and treatment and support programs for people with HIV/AIDS in the United States.
The Ryan White Program is administered by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS).
The program was first enacted in 1990. The program has been reauthorized by Congress four times since first created (in 1996, 2000, 2006, and 2009).
The Ryan White Program is a “payer of last resort” program that exists to provide coverage, care, and treatment, for those who have no other source of coverage or face coverage limits.The program is currently authorized through September 30, 2013 after which time it can continue to operate through Congressional appropriations with or without subsequent legislation.
Funding for the Ryan White program is subject to Congressional appropriations each year. It is the third largest source of federal funding for HIV care in the U.S., after Medicare and Medicaid reaches more than half a million people with HIV each year. In addition to federal funding, some states and localities also provide funding to their Ryan White services (including through certain state matching funds requirements).
Part C of the Ryan White Program funds medical providers who deliver comprehensive medical care and treatment to people with HIV who have no other source for care.
Another vitally important program for HIV patients is the AIDS Drug Assistance Program (ADAP), which is funded through Part B of the Ryan White Program.
Health Reform:
The health reform law passed in 2010, the Patient Protection and Affordable Care Act (the “ACA”), has implications for the Ryan White Program.
Starting in 2014 many of Ryan White patients who receive care and treatment through the Ryan White program will begin to receive coverage through other programs created under the ACA. A majority will become part of the new Medicaid expansion; another portion are likely to gain coverage through the State Insurance Exchanges.
Because Ryan White is a “payer of last resort” program, those patients who will have access to the new programs must use them first.
However, since the states have significant flexibility in establishing the new programs, it is possible that some former Ryan White patients may end up with insufficient benefits, inadequate access to medications, or possibly even less than adequate access to care. They may also see new or increased co-pays, deductibles, or other cost-sharing. It is possible that the Ryan White Program may be able to aid in supplementing some of these areas.
Ryan White providers and clinics will likely need to join these new systems, and become included in the new networks of care. Providers need to pay attention to the requirements and opportunities in their state to be included in the billing networks, referral networks, and care networks for their state’s Exchanges and state Medicaid program. HRSA continues to work toward increased coordination between Medicaid and the Ryan White Program.
The most significant provisions of the ACA do not take effect until 2014, and their overall effects will not become clear until sometime after that. The Ryan White Program as a whole will likely see many changes in the future. Some of these may include the types of patients accessing services, to what services are provided, how those services wrap around the new systems.
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