OAR 333-022-1000: CareAssist: Purpose and Description of Program

(1) The CAREAssist program is Oregon’s AIDS Drug Assistance Program (ADAP). The core purpose of CAREAssist is to ensure access to HIV-related prescription drugs to underinsured and uninsured individuals living with HIV/AIDS. CAREAssist also helps people living with HIV or AIDS pay for medical care expenses, including but not limited to medication, insurance premiums and medical services. The program is funded through Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87), which provides grants to states and territories. (2) The Oregon Health Authority (Authority) shall make funds available for the CAREAssist program as long as it continues to receive grant funds from the federal government. (3) If insufficient funds are available for the CAREAssist program the Authority may: (a) Modify group benefits for approved clients; and (b) Institute a waiting list in lieu of accepting applications. (4) Ryan White funds may not be used for any item or service if payment has been made, or can reasonably be expected to be made by another payment source. ADAP is a last-resort payment source. As such, the Authority may require the applicant or client to enroll in the most cost-effective insurance available, as determined by the Authority. If the client or applicant refuses to enroll in health insurance that the Authority has identified as the most cost-effective plan for which he or she is eligible, the Authority shall only provide assistance with the cost of HIV antiretroviral, Hepatitis antiviral and opportunistic infection-related medications as identified in the formulary.