Ryan White Provider Resources

In this section, Ryan White providers can find the client intake, recertification forms, and support documents.

AIDS Drug Assistance Program (ADAP)

Idaho’s AIDS Drug Assistance Program (ADAP) helps people living with HIV or AIDS pay for prescriptions. Learn more about Idaho’s updated ADAP formulary as new medications are added.

Download and view Provider Prior Authorization forms

Cabenuva Provider Update -  Prime Therapeutics will begin processing reimbursements for administration of Cabenuva injections and for related Cabenuva office visits on behalf of Idaho AIDS Drug Assistance Program (ADAP) clients. A claims form will need to be submitted with each reimbursement, view a copy of the ID ADAP claims form. Read more for answers to Frequently Asked Questions.

ADAP 30-day Dispensing Update

Effective May 12, 2025, all pharmacy claims will be restricted to a 30-day supply as part of our cost-control measures. Idaho ADAP will no longer allow 90-day supply claims, except in cases where an exception is granted (no exceptions will be allowed for Biktarvy). View the Idaho ADAP Pharmacy Notice.

More information about the Ryan White Program

Eligibility requirements

The eligibility requirements for the AIDS Drug Assistance Program (ADAP) and the Ryan White Part B Medical Case Management include the following:

  1. HIV-positive
  2. Idaho resident
  3. Have income at or below 500 percent of the Federal Poverty Level
  4. Not insured or underinsured for medications and HIV monitoring labs
  5. Not an inmate of state or federal Corrections system

If your income is at or below 138% FPL, you may be eligible for Medicaid and should Apply for Medicaid | Idaho Department of Health and Welfare

Family SizeUnder 138% FPL
121,597.00
2$29,187.00
3$36,777.00
4$44,367.00
5$51,957.00
6$59,547.00

     *Medicaid may have additional eligibility requirements such as resource limits.

Services

Core Medical Services

The Ryan White HIV/AIDS Program legislation specifies that the following 13 core medical services are allowable. Grantees must ensure that RWHAP Part B services are provided within the scope of the service category definitions provided by HRSA/HAB. 

  1. Outpatient and ambulatory health services*
  2. AIDS Drug Assistance Program treatments*
  3. Oral health care*
  4. Home and community-based health services*
  5. Mental health services*
  6. Substance abuse outpatient care*
  7. Medical case management, including treatment adherence services
  8. Early intervention services
  9. AIDS pharmaceutical assistance
  10. Health insurance premium and cost sharing assistance for low-income individuals
  11. Home health care
  12. Medical nutrition therapy
  13. Hospice services 

*Core medical services funded by the Idaho Ryan White Part B program

Support Services

The Ryan White HIV/AIDS Program legislation also provides for allowable support services.  Grantees must ensure that RWHAP Part B services are provided within the scope of the service category definitions provided by HRSA/HAB. 

  1. Case management (non- medical) **
  2. Emergency financial assistance**
  3. Food bank/home-delivered meals**
  4. Linguistics services (interpretation and translation) **
  5. Medical transportation services**
  6. Childcare services
  7. Health education/risk reduction
  8. Housing services
  9. Legal services
  10. Outreach services
  11. Psychosocial support services
  12. Referral for health care/supportive services
  13. Rehabilitation services
  14. Respite care
  15. Substance abuse services—residential
  16. Treatment adherence counseling 

**Support services funded by the Idaho Ryan White Part B program

Ryan White Consumer Complaint Policy

The Idaho Ryan White Part B Program is committed to assuring that no infringement of a client’s rights occurs at an agency funded by the program, and that there is an established procedure for addressing problems or complaints that clients may have. Clients participating in HIV medical case management and ADAP have the opportunity to voice their concerns or receive additional assistance if needed.

RWPB Consumer Complaint Policy- English

RWPB Consumer Complaint Policy- Spanish 

 

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