Program HH Policy Manual

What is Program HH?

The Ryan White HIV/AIDS Treatment Extension Act of 2009 codifies a variety of core medical and support services provided to eligible people with human immunodeficiency viruses (HIV). The Minnesota Department of Human Services (DHS) administers Ryan White program services for eligible people with HIV under Program HH.

Program HH provides access to crucial medications and care services for people with HIV in Minnesota. It includes the Minnesota AIDS Drug Assistance Program (ADAP) and Part B programs, which are described in the following sections.

Minnesota ADAP

ADAP provides low-income people with HIV access to medical services and antiretroviral medication. ADAP includes three programs.

Drug Benefit

The Drug Benefit covers the outpatient drug cost of antiretroviral and other HIV-related medications or medication deductibles, coinsurance and copayments for people who are eligible. For more information, refer to:

· Program HH Policy Manual – Drug Benefit.

· MHCP Provider Manual – Program HH services – Drug Benefit.

Insurance Premium Assistance (IPA)

IPA covers the full or partial cost of health insurance premiums for people who are eligible. For more information, refer to Program HH Policy Manual – IPA.

Limited Medication Therapy Management Services (MTMS)

MTMS covers costs for people who use Program HH to understand the importance of their drug regiment, issues with compliance and possible side effects. It also offers ongoing support for medication adherence. People who use Program HH may receive MTMS if they are currently taking medication or have a prescription for medication but have not yet started it. For more information, refer to Program HH Policy Manual – Part B programs – MTMS.

Part B programs

Program HH includes the following Part B programs.

Dental Benefit

The Dental Benefit covers routine and non-routine dental services for people who use Program HH. For more information, refer to:

· Program HH Policy Manual – Part B programs – Dental Benefit.

· MHCP Provider Manual – Program HH services – Dental Benefit.

Mental Health Benefit

The Mental Health Benefit covers limited mental health services for people who use Program HH. It covers limited outpatient services, including certain diagnostic assessments and psychotherapy services. The Mental Health Benefit does not cover medications, but several mental health medications are included in DHS – Program HH Medication Program (ADAP) Formulary.

For more information, refer to:

· Program HH Policy Manual – Part B programs – Mental Health Benefit.

· MHCP Provider Manual – Program HH services – Mental Health Benefit.

Nutritional Supplement Benefit

The Nutritional Supplement Benefit covers enteral nutritional products when recommended by a registered dietician, up to a certain dollar amount per calendar month for people approved for the benefit.

For more information, refer to:

· Program HH Policy Manual – Part B programs – Nutritional Supplement Benefit.

· MHCP Provider Manual – Program HH services – Nutritional Supplement Benefit.

Who administers Program HH?

HIV Benefits and Eligibility program staff at DHS are responsible to administer Program HH, including developing policies and procedures that align with relevant state statutes, federal Ryan White legislation and other federal funding requirements.

How is Program HH funded?

Program HH is funded through:

· Federal Ryan White Part B funds administered by the Health Resources and Services Administration (HRSA), including ADAP earmark, supplemental and emergency relief funds.

· State funds appropriated by the Minnesota Legislature.

· 340B rebates from drug manufacturers.

What is Program HH’s history?

In 1986, DHS started an HIV case management program. The program used Medicaid administrative dollars that went into a grant to the Minnesota AIDS Project (now Rainbow Health Minnesota). In July 1988, there were three DHS-funded medical case managers serving people with HIV.

In 1987, Minnesota began an azidothymidine (AZT) program using federal funds (refer to HSRA – AZT program launches). In the 1990s, Minnesota added additional state money to the program.

In 1990, DHS used state funds to create an insurance program (refer to Minn. Stat. §256.9365).

Currently, the Drug Benefit has expanded in scope, from covering all HIV retroviral medications to an open formulary that mirrors Minnesota’s Medical Assistance program. Insurance Premium Assistance has expanded in scope to cover certain individual health insurance policies, including public programs and Medicare. DHS also added to Program HH coverage for some Part B services, as explained in the sections above.

What are Program HH’s goals?

By providing people with HIV access to medical care and antiretroviral medications, Program HH works to promote the primary goals of the National HIV/AIDS Strategy and the Minnesota HIV Strategy to End HIV/AIDS:

· Reduce the number of new HIV infections.

· Increase access to care and optimize health outcomes.

· Reduce HIV-related health disparities.

What’s new in this policy manual?

DHS will announce changes and additions to the Program HH Policy Manual in this section.

Date	Page	Action
8/30/22	Home page	Comprehensive review with the following changes: · Updated the title to “Program HH Policy Manual” · Added information about the programs and services available under Program HH
August 2022 (various dates)	· Eligibility requirements · Application process · Drug Benefit · Insurance Premium Assistance · Information for insurance companies – Program HH Part B programs · Confidentiality and record retention · Program HH resources · Sources of income and acceptable verification documents	Comprehensive review to add clarity and align with recent HRSA policy changes, including: · Eliminating the requirement for people who use Program HH to complete a six-month recertification · Clarifying the people who count toward household size and income · Aligning language across manual pages.