DOH anticipates AIDS drug fix will become law

The Department of Health (DOH) started to “operationalize” Wednesday morning, preparing an emergency rule to return income eligibility for the AIDS Drug Assistance Program (ADAP) to 400% of the federal poverty level, a DOH attorney said.

DOH outside attorney Eduardo Lombard told Leon County Circuit Court Judge Jonathan Sjostrom Wednesday that the Department anticipates HB 697, passed by the Senate Tuesday night and sent to the House, to soon become law.

Given the fluidity of the ADAP funding and Friday’s scheduled end of the 60-day Legislative Session, Sjostrom agreed to reschedule the hearing for March 20, if necessary.

“I’ll say the following, because my client anticipates that it is going to make it to the finish line, all the way and become law, they have already begun today, this morning, to operationalize,” Lombard told the Judge during an evidentiary hearing on the AIDS Healthcare Foundation’s request for a temporary injunction to block the Gov. Ron DeSantis administration from drastically paring back eligibility for the program.

DOH published an emergency rule to cut ADAP eligibility from 400% of the federal poverty level to 100% and to limit the drugs ADAP beneficiaries can access. The changes were being made to abate a purported $120 million shortfall in the program.

The National Alliance of State and Territorial AIDS Directors estimates that about 16,000 Florida residents who benefit from ADAP would be harmed by the change.

Lombard told the judge that DOH staff was preparing so that when the bill becomes law the department can “drop the emergency rule that that bill commands of us.”

In addition to providing money, the bill as amended specifically would direct the DOH to pass emergency rules to incorporate the changes to ADAP that are outlined in the bill.

The emergency rules would stay in effect until the end of June.

“They have already begun today, this morning, to operationalize,” Lombard told the Judge. He added that DOH will be “prepared upon that bill becoming law” to publish a new emergency rule.

While DOH is confident the bill will pass the House and be signed by the Governor, House Speaker Daniel Perez told reporters Tuesday night he still had to review the policy and made no commitment that it would pass the House.

“I have to make sure that I feel comfortable with that and that it’s in the best interest of the state. I haven’t seen all the details yet. I’m going to get briefed on it,” Perez told reporters Tuesday night.

Specifically, HB 697 would return through June 30 ADAP income eligibility to 400% of the federal poverty level, which is an income of $62,600 annually for an individual. DOH would be required to provide ADAP enrollees with the medications through direct distribution but they only would be authorized to ship medications listed on DOH’s March 1 formulary. That formulary doesn’t include Biktarvy, a daily pill taken by some HIV and AIDS patients.

HB 697 also would require DOH — which kept the Legislature in the dark about a $120 million deficit — to submit monthly budget reports. DOH would be required to include in the report the amount of federal revenues and expenditures for the ADAP program, including drug manufacturer rebates, the number of ADAP participants, the counties in which they live, their health insurance status, and the number and type of prescriptions filled, including use by drug class.

The monthly reports also would be required to include monthly and year-to-date trend analyses and flag any funding shortfalls, enrollment pressures, or operational risks anticipated through the end of June.